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Early replacement of a new central venous catheter (CVC) may pose a risk of persistent or recurrent infection in patients with a catheter-related bloodstream infection (CRBSI). We evaluated the clinical impact of early CVC reinsertion after catheter removal in patients with CRBSIs.
Methods:
We conducted a retrospective chart review of adult patients with confirmed CRBSIs in 2 tertiary-care hospitals over a 7-year period.
Results:
To treat their infections, 316 patients with CRBSIs underwent CVC removal. Among them, 130 (41.1%) underwent early CVC reinsertion (≤3 days after CVC removal), 39 (12.4%) underwent delayed reinsertion (>3 days), and 147 (46.5%) did not undergo CVC reinsertion. There were no differences in baseline characteristics among the 3 groups, except for nontunneled CVC, presence of septic shock, and reason for CVC reinsertion. The rate of persistent CRBSI in the early CVC reinsertion group (22.3%) was higher than that in the no CVC reinsertion group (7.5%; P = .002) but was similar to that in the delayed CVC reinsertion group (17.9%; P > .99). The other clinical outcomes did not differ among the 3 groups, including rates of 30-day mortality, complicated infection, and recurrence. After controlling for several confounding factors, early CVC reinsertion was not significantly associated with persistent CRBSI (OR, 1.59; P = .35) or 30-day mortality compared with delayed CVC reinsertion (OR, 0.81; P = .68).
Conclusions:
Early CVC reinsertion in the setting of CRBSI may be safe. Replacement of a new CVC should not be delayed in patients who still require a CVC for ongoing management.
To determine the level of vitamin D and to identify the association between vitamin D and depressive symptoms in apparently healthy Korean male adults.
Design:
A retrospective study design. Among 43 513 participants between 1 March and 30 November 2018, after eliminating participants with a history of depression or vitamin D deficiency, 9058 were included. To determine the level of vitamin D, serum 25-hydroxyvitamin D [25(OH)D] was measured. To assess the level of depression, the Korean version of the Center for Epidemiologic Studies Depression Scale (CES-D) was used.
Setting:
South Korea.
Participants:
Male adults who underwent routine health check-ups.
Results:
The average vitamin D level was 22·31 ± 7·09 ng/ml as 25(OH)D, while the number of subjects in the vitamin D insufficiency group with a finding of <20 ng/ml was 3783 (41·8 %). The mean CES-D score in all subjects was 8·31 ± 5·97 points, and the proportion of the depressive symptoms group with a score of ≥16 was 8·71 %. The OR of patients in the depressive symptoms group also being in the insufficiency group was found to be 1·49 (95 % CI 1·12, 2·00).
Conclusions:
A total of 41·8 % of apparently healthy male adults had vitamin D levels <20 ng/ml. We identified an association between vitamin D insufficiency and depressive symptoms in apparently healthy Korean male adults.
While normative data on neuropsychological performance provide baseline metrics for the assessment and diagnosis of mild cognitive impairment and dementia, a lack of comparative normative data in non-Caucasian populations makes it difficult to conduct similar evaluations and studies in individuals from diverse backgrounds. The current paper aims to provide normative data on a range of cognitive measures in a Korean general population sample and investigate various demographic and health variables associated with cognitive performance in this representative population.
Method(s):
The study population was 1,528 stroke and dementia-free individuals who participated in the Korean Genome and Epidemiology study (KoGES) (mean age 60.43 ± 7.30, 52.42% female). All participants underwent a comprehensive neuropsychological test battery that included verbal and visual memory, language, attention, and executive function measures. A health examination and a questionnaire-based interview were also administered.
Results:
The majority of cognitive test results were associated with age, education, and gender. In general, higher education and younger age was associated with better cognitive performance. Explained variance increased modestly in models that included measures of general health and depressive symptoms.
Conclusion:
Normative data of cognitive performance in a community based Korean population are presented. These norms provide reference values in a non-Caucasian middle to older aged sample.
In interpreting radiocarbon dating results, it is important that archaeologists distinguish uncertainties derived from random errors and those from systematic errors, because the two must be dealt with in different ways. One of the problems that archaeologists face in practice, however, is that when receiving dating results from laboratories, they are rarely able to critically assess whether differences between multiple 14C dates of materials are caused by random or systematic errors. In this study, blind tests were carried out to check four possible sources of errors in dating results: repeatability of results generated under identical field and laboratory conditions, differences in results generated from the same sample given to the same laboratory submitted at different times, interlaboratory differences of results generated from the same sample, and differences in the results generated between inner and outer rings of wood. Five charred wood samples, collected from the Namgye settlement and Hongreyonbong fortress, South Korea, were divided into 80 subsamples and submitted to five internationally recognized 14C laboratories on a blind basis twice within a 2-month interval. The results are generally in good statistical accordance and present acceptable errors at an archaeological scale. However, one laboratory showed a statistically significant variance in ages between batches for all samples and sites. Calculation of the Bayesian partial posterior predictive p value and chi-squared tests rejected the null hypothesis that the errors randomly occurred, although the source of the error is not specifically known. Our experiment suggests that it is necessary for users of 14C dating to establish an organized strategy for dating sites before submitting samples to laboratories in order to avoid possible systematic errors.
A total of forty weaned pigs ((Landrace×Yorkshire)×Duroc) were used to evaluate the effects of Lactobacillus acidophilus on inflammatory activity after lipopolysaccharide (LPS) challenge. Experimental treatments were as follows: (T1) control diet+saline challenge; (T2) control diet with 0·1 % L. acidophilus+saline challenge; (T3) control diet+LPS challenge; and (T4) control diet with 0·1 % L. acidophilus+LPS challenge. On d-14, piglets were challenged with saline (T1 and T2) or LPS (T3 and T4). Blood samples were obtained at 0, 2, 4, 6 and 12 h after being challenged and analysed for immune cell cytokine production and gene expression pattern. The L. acidophilus treatment increased the average daily weight gain (ADWG) and average daily feed intake (ADFI) compared with the control diet. With the control diet, the LPS challenge (T3) increased the number of immune cells and expression of TNF-α and IL-6 compared with the saline challenge (T1). Whereas with the saline challenge L. acidophilus treatment (T2) increased the number of leucocytes and CD4 compared with the control diet (T1), with the LPS challenge L. acidophilus treatment (T4) decreased the number of leucocytes, lymphocytes, CD4+ and CD8+ and expression of TNF-α and IL-6 compared with the control diet (T3). L. acidophilus treatment decreased the expression of TRL4 and NF-κB in peripheral blood mononuclear cells (PBMC) after LPS challenge, which leads to inhibition of TNF-α, IFN-γ, IL-6, IL-8 and IL1B1 and to induction of IL-4 and IL-10. We suggested that L. acidophilus improved ADWG and ADFI and protected against LPS-induced inflammatory responses by regulating TLR4 and NF-κB expression in porcine PBMC.
We report on the formation of highly flexible and transparent TiO2/Ag/ITO multilayer films deposited on polyethylene terephthalate substrates. The optical and electrical properties of the multilayer films were investigated as a function of oxide thickness. The transmission window gradually shifted toward lower energies with increasing oxide thickness. The TiO2 (40 nm)/Ag (18 nm)/ITO (40 nm) films gave the transmittance of 93.1% at 560 nm. The relationship between transmittance and oxide thickness was simulated using the scattering matrix method to understand high transmittance. As the oxide thickness increased from 20 to 50 nm, the carrier concentration gradually decreased from 1.08 × 1022 to 6.66 × 1021 cm−3, while the sheet resistance varied from 5.8 to 6.1 Ω/sq. Haacke's figure of merit reached a maximum at 40 nm and then decreased with increasing oxide thickness. The change in resistance for the 60 nm-thick ITO single film rapidly increased with increasing bending cycles, while that of the TiO2/Ag/ITO (40 nm/18 nm/40 nm) film remained virtually unchanged during the bending test.
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.
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).
Method:
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).
Results:
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.
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.
Methods:
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.
Results:
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.
Conclusion:
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.
Cast AZ31B-H24 magnesium alloy, comprising Mg with 3.27 wt% Al and 0.96 wt% Zn, was cold rolled and subsequently annealed. Global texture evolutions in the specimens were observed by X-ray diffractometry after the thermomechanical processing. Image-based microstructure and texture for the deformed, recrystallized, and grown grains were observed by electron backscattered diffractometry. Recrystallized grains could be distinguished from deformed ones by analyzing grain orientation spread. Split basal texture of ca. ±10–15° in the rolling direction was observed in the cold-rolled sample. Recrystallized grains had widely spread basal poles at nucleation stage; strong {0001} basal texture developed with grain growth during annealing.
ZK60 (Mg–Zn–Zr) alloys exhibited a variation in precipitates with aging, and their mechanical properties also changed. Microindentation tests were carried out on two types of ZK60 alloys of solid solution (T4) and peak aging (T6). Microstructure and texture evolution during indentation was investigated using electron backscatter diffraction. Twinning occurred near the indentation marks in most grains. It was found that tensile twinning was dominant, and two twin variants were usually observed. Texture and microstructure evolution by twinning and slip activation was further examined by uniaxial compression test with strain. The initial random orientation gradually changed into basal fibers with strain. Some grains with nonbasal orientations aligned with the loading direction easily underwent twinning followed by slip deformation. Other grains near basal orientations revealed only slip deformation.
Resistance degradation of zirconium (Zr)-doped barium titanate (BaTiO3) was investigated. A series of Ba(Ti1−yZry)O3 powders and coarse-grained ceramics ranging y from 0 to 0.1 were prepared. The increase of Zr concentration systematically increased the time to as well as electric field to degradation. Such behaviors directly corresponded to those of ionic conduction contribution as evaluated by the Warburg impedance. The magnitude of Warburg impedance decreased with the increase of Zr concentration, which demonstrates that the Zr incorporation inhibits the ionic conduction caused by oxygen vacancies. The prototype multilayer ceramic capacitor (MLCC) samples were also prepared by applying these Ba(Ti1−yZry)O3 base powders and formulated X5R additives of commercial application. In this case, however, such distinct difference in degradation behavior with the variation of Zr concentration did not appear. It is supposed that the influence of additives far outweighs the effect of relative difference in the ionic conduction of Ba(Ti1−yZry)O3 under the MLCC test condition where the applied electric field strength is much higher than those for the coarse-grained bulk ceramics. Resistance degradation of MLCC under such high field might not be explained by only oxygen vacancy-related behavior alone.
To evaluate the prevalence of vitamin D deficiency and predictors for low vitamin D status in Korean adolescents living between latitudes 33° and 39°N.
Design
A descriptive cross-sectional study.
Setting
Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2009.
Subjects
A total of 1510 healthy adolescents aged 12–18 years (806 male, mean age 14·7 years) participated. Possible predictors for low vitamin D status (log-transformed 25-hydroxyvitamin D (25(OH)D) concentrations) were evaluated.
Results
The prevalence of vitamin D deficiency (25(OH)D<20 ng/ml) was 89·1 % in spring, 53·7 % in summer, 63·9 % in autumn and 90·5 % in winter. Winter season, older age, higher education level reached, being female, being obese, a lack of vitamin D supplementation, lower milk consumption (0–<200 ml/d) and a lack of physical activity were unadjusted predictors (all P < 0·05). Multiple linear regression analysis showed that winter season (P < 0·001), higher education level (P < 0·001) and a lack of vitamin D supplementation (P = 0·012) were independent predictors for low vitamin D status. The modifying effect of season on the association between vitamin D supplement use and vitamin D status was significant (P < 0·001).
Conclusions
Vitamin D deficiency was highly prevalent in Korean adolescents, especially those in higher school grades. Vitamin D supplementation may contribute to maintain a better vitamin D status with lower seasonal variation. Further studies are required to determine optimal vitamin D intakes to maintain sufficient vitamin D status for Korean adolescents.
This study investigated the inflammatory effect of intraoperative mitomycin C (MMC) on adhesion reformation in human rectus muscles. Ten consecutive patients who underwent medial rectus resection had their postoperative rectus muscles divided into two groups: control group (n = 10) and MMC group (n = 10). In the MMC group, the muscle was soaked for 2 min with MMC, prepared as a 0.2 mg/mL (0.02%) solution. The 0.02% MMC reactions were examined using histological analysis with hematoxylin-eosin (inflammatory response) and Masson's trichrome (collagen fibrils), immunoreactivities of cyclooxygenase-II (inflammatory response), and collagen type I and III, scanning electron microscopy analysis to quantify the diameter and D-periodicity of collagen fibrils, and atomic force microscopy analysis to quantify the diameter, D-periodicity, and adhesion force of collagen fibrils. The rectus muscles treated with 0.02% MMC showed a significantly increased inflammatory response (p < 0.05), increased collagen density (p < 0.0001), increased fibril diameter (p < 0.001 or p < 0.05), and decreased fibril adhesion force (p < 0.005) compared to the rectus muscles in the control group. MMC simultaneously caused an inflammatory response as well as nanostructural and biomechanical property changes in the collagen fibril network.
The electroluminescent characteristics of blue organic light-emitting diodes(BOLEDs) were fabricated with single emitting layer using host-dopant system and doped charge carrier transport layers. The structure of the high efficiency BOLED device was; NPB(600Å)/NPB:BCzVBi-7%(100Å)/ADN:BCzVBi-7%(300Å)/BAlq:BCzVBi-7%(100Å)/BAlq(200Å)/Liq(20Å)/Al(1200Å) to optimize probability of exciton generation by doping BCzVBi in emitting layer and hole/electron transport layers(HTL/ETL) as well. Luminance and luminous efficiency of BOLED doped BCzVBi in EML and HTL/ETL improved from 10090 cd/m2 at 9.5V and 6.44 cd/A at 4.0V to 13190 cd/m2 at 9.5V and 7.64 cd/A at 4.0V about 30% and 18%, respectively, with CIE coordinates of (0.14, 0.17) comparing to BOLED doped BCzVBi in EML only
In this study, we fabricated blue OLEDs with quantum well structure (QWS) using four different blue emissive materials such as DPVBi, ADN and DPASN, and BAlq as QWS material. Conventional QWS blue OLEDs used to be composed of emissive layer and charge blocking layer with lower HOMO-LUMO energy level, but we designed triple emitting layer for more significant hole-electron recombination in EML and a wider region of exciton generation as forming QWS spontaneously. The structure of triple emitting layered blue OLED is ITO / NPB(700 Å) / X(100 Å) / BAlq(100 Å) /X (100 Å) / Bphen(300 Å) / Liq(20 Å) / Al(1200 Å) (X= DPVBi, ADN, DPASN). HOMO-LUMO energy levels of DPVBi, ADN, DPASN and BAlq were 2.8-5.9, 2.6-5.6, 2.3-5.2 and 2.9-5.9 eV, respectively. The maximum luminous efficiency was 5.32 cd/A at 3.5 V in a blue OLED with DPASN / BAlq / DPASN QWS.
Background: Mortality associated with depression may be influenced by severity of depression and gender. We investigated the differential impacts on all-cause mortality of late-life depression by the type of depression (major depressive disorder, MDD; minor depressive disorder, MnDD; subsyndromal depression, SSD) and gender after adjusting comorbid conditions in the randomly sampled elderly.
Methods: One thousand community-dwelling elderly individuals were enrolled. Standardized face-to-face clinical interviews, neurological examination, and physical examination were conducted to diagnose depressive disorders and comorbid cognitive disorders. Depressive disorders were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria and SSD to study-specific operational criteria. Five-year survivals were compared between groups using Cox proportional hazards models.
Results: By the end of 2010, 174 subjects (17.4%) died. Depressive disorder (p = 0.001) and its interaction term with gender (p < 0.001) were significant in predicting five-year survival. MDD was an independent risk factor for mortality in men (hazard ratio = 3.65, 95% confidence interval = 1.67–7.96) whereas MnDD and SSD were not when other risk factors were adjusted.
Conclusions: MDD may directly confer the risk of mortality in elderly men whereas non-major depression may be just an indicator of increased mortality in both genders.
Through a polyethylene-glycol-assisted hydrothermal method, a series of potassium fluoride (KF)–Yttrium (III) fluoride (YF3) system materials have been synthesized. By controlling the reactant ratios of KF: rare earth ions (RE3+), the hydrothermal temperatures, and the pH values of the prepared solutions, the final products can evolve among the orthorhombic phase of YF3 and/or the tetragonal phase of potassium triyttrium decafluoride (KY3F10) and/or the cubic phase of potassium yttrium tetrafluoride (KYF4). The final products are characterized by the x-ray diffraction (XRD) patterns, the field-emission scanning electron microscopy (FE-SEM) images, the energy-dispersive spectroscopy (EDS) patterns, the photoluminescence (PL) spectra, and the luminescent dynamic decay curves. The XRD patterns of the samples suggest the phase evolution of the final products. The FE-SEM images and the EDS patterns prove that. Europium ion (Eu3+) acting as a probe, its PL spectra and the luminescent decay curves all put together prove the phase evolution of the final products. The research can be extended to study the other KF–REF3 system materials.