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Network approach has been applied to a wide variety of psychiatric disorders. The aim of the present study was to identify network structures of remitters and non-remitters in patients with first-episode psychosis (FEP) at baseline and the 6-month follow-up.
Participants (n = 252) from the Korean Early Psychosis Study (KEPS) were enrolled. They were classified as remitters or non-remitters using Andreasen's criteria. We estimated network structure with 10 symptoms (three symptoms from the Positive and Negative Syndrome Scale, one depressive symptom, and six symptoms related to schema and rumination) as nodes using a Gaussian graphical model. Global and local network metrics were compared within and between the networks over time.
Global network metrics did not differ between the remitters and non-remitters at baseline or 6 months. However, the network structure and nodal strengths associated with positive-self and positive-others scores changed significantly in the remitters over time. Unique central symptoms for remitters and non-remitters were cognitive brooding and negative-self, respectively. The correlation stability coefficients for nodal strength were within the acceptable range.
Our findings indicate that network structure and some nodal strengths were more flexible in remitters. Negative-self could be an important target for therapeutic intervention.
In South Korea, the law concerning automated external defibrillators (AEDs) states that they should be installed in specific places including apartment complexes. This study was conducted to investigate the current status and effectiveness of installation and usage of AEDs in South Korea.
Installation and usage of AEDs in South Korea is registered in the National Emergency Medical Center (NEMC) database. Compared were the installed number, usage, and annual rate of AED use according to places of installation. All data were obtained from the NEMC database.
After excluding AEDs installed in ambulances or fire engines (n = 2,003), 36,498 AEDs were registered in South Korea from 1998 through 2018. A higher number of AEDs were installed in places required by the law compared with those not required by the law (20,678 [56.7%] vs. 15,820 [43.3%]; P <.001). Among them, 11,318 (31.0%) AEDs were installed in apartment complexes. The overall annual rate of AED use was 0.38% (95% CI, 0.33-0.44). The annual rate of AED use was significantly higher in places not required by the law (0.62% [95% CI, 0.52-0.72] versus 0.21% [95% CI, 0.16-0.25]; P <.001). The annual rate of AED use in apartment complexes was 0.13% (95% CI, 0.08-0.17).
There were significant mismatches between the number of installed AEDs and the annual rate of AED use among places. To optimize the benefit of AEDs in South Korea, changes in the policy for selecting AED placement are needed.
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.
Several studies on the treatment of coronavirus disease 2019 (COVID-19) are being conducted, and various drugs are being tried; however, the results have not been uniform. Steroids have been widely used in the treatment of COVID-19, but their effects are controversial. As immunosuppressive and anti-inflammatory agents, steroids are considered to reduce lung damage by regulating various inflammatory responses. We report a case of severe acute respiratory syndrome coronavirus-2 pneumonia manifesting as a cryptogenic organizing pneumonia-like reaction and discuss its treatment, clinical course, and favorable outcomes after steroid administration.
Hyperlipidaemia is a major cause of atherosclerosis and related CVD and can be prevented with natural substances. Previously, we reported that a novel Bacillus-fermented green tea (FGT) exerts anti-obesity and hypolipidaemic effects. This study further investigated the hypotriglyceridaemic and anti-obesogenic effects of FGT and its underlying mechanisms. FGT effectively inhibited pancreatic lipase activity in vitro (IC50, 0·48 mg/ml) and ameliorated postprandial lipaemia in rats (26 % reduction with 500 mg/kg FGT). In hypertriglyceridaemic hamsters, FGT administration significantly reduced plasma TAG levels. In mice, FGT administration (500 mg/kg) for 2 weeks augmented energy expenditure by 22 % through the induction of plasma serotonin, a neurotransmitter that modulates energy expenditure and mRNA expressions of lipid metabolism genes in peripheral tissues. Analysis of the gut microbiota showed that FGT reduced the proportion of the phylum Firmicutes in hamsters, which could further contribute to its anti-obesity effects. Collectively, these data demonstrate that FGT decreases plasma TAG levels via multiple mechanisms including inhibition of pancreatic lipase, augmentation of energy expenditure, induction of serotonin secretion and alteration of gut microbiota. These results suggest that FGT may be a useful natural agent for preventing hypertriglyceridaemia and obesity.
This study investigates the relationship between insomnia and cognitive dysfunctions including, subjective memory impairment (SMI), mild cognitive impairment (MCI), and dementia, by considering depression in a community sample of elderly individuals.
Data for 1,740 elderly individuals aged 65 years and over were obtained from a nationwide dementia epidemiological study conducted in South Korea. Cognitive functional status was assessed by the Mini-Mental State Examination and the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet Clinical Assessment Battery. Insomnia was defined as the presence of at least one of the four sleep complaints (difficulty in initiating sleep, difficulty in maintaining sleep, early morning awakening, and non-restorative sleep), accompanied by moderate to severe daytime consequences. Depression was evaluated using the Geriatric Depression Scale.
The prevalence of insomnia in the patients with SMI, MCI, and dementia was found to be 23.2%, 19.6%, and 31.0%, respectively. The patients with SMI, MCI, and dementia were significantly more likely to have insomnia and the four sleep complaints than the normal comparison patients. After adjusting for sociodemographic factors, the significant relationships between cognitive dysfunctional status and insomnia remained. However, after adjusting for sociodemographic factors and depression, no significant relationships with any of the sleep complaints or insomnia remained.
Insomnia is a very common complaint in the elderly with SMI, MCI, and dementia. Depression might play an important factor in the relationship between insomnia and cognitive dysfunctional status in the elderly.
According to the US Affordable Care Act, restaurant chains are required to provide energy (calorie) and other nutrition information on their menu. The current study examined the impact of menu labelling containing calorie information and recommended daily calorie intake, along with subjective nutrition knowledge, on intention to select lower-calorie foods prior to the implementation of the Affordable Care Act.
Full factorial experimental design with participants exposed to four variants of a sample menu in a 2 (presence v. absence of calorie information) ×2 (presence v. absence of recommended daily calorie intake).
Large, public university in the Southwest USA.
Primarily undergraduate college students.
Majority of participants were 19–23 years of age (mean 21·8 (sd 3·6) years). Menu information about calorie content and respondents’ subjective nutrition knowledge had a significantly positive impact on students’ intention to select lower-calorie foods (β=0·24, P<0·001 and β=0·33, P<0·001, respectively); however, recommended daily calorie intake information on the menu board did not influence students’ intention to select lower-calorie foods (β=0·10, P=0·105). Gender played a significant role on purchase intent for lower-calorie menu items, with females more affected by the calorie information than males (β=0·37, P<0·001).
Findings support the role menu labelling can play in encouraging a healthier lifestyle for college students. College students who are Generation Y desire healthier menu options and accept nutritional labels on restaurant menus as a way to easily and expediently obtain nutrition information.
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.
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.
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).
Early pain control in patients with suspected appendicitis does not affect the diagnostic performance of surgical residents.
Since 1994, the KHNP has developed a vitrification technology to treat the LILW generated from Korean nuclear power plant. To vitrify the LILW including combustible Dry Active Waste (DAW) and Ion Exchange Resin (IER) containing Zeolite, two borosilicate glasses are formulated. One of the formulated glass, DG2, is for the DAW vitrification solely and the other one, AG8W1, is for the blended wastes (DAW & IER) vitrification in a commercial vitrification facility in HanUl (former Ulchin) nuclear power plant. The physicochemical properties of the two glasses have been evaluated. To evaluate the processability of the glasses, the viscosities and electrical conductivities of the glass melts were measured in the laboratory within a temperature range between 950 and 1,350 degrees C, respectively. The liquidus temperatures of the glasses were evaluated using a gradient furnace for DG2 and data from heat treatment for AG8W1. The Mössbauer spectroscopy for AG8W1 was employed to evaluate the relations between the redox equilibria of iron. In addition, to verify the waste acceptance criteria for the final disposal of the vitrified forms, the compressive strengths of the vitrified forms were tested after an immersion test, a thermal cycling test, and an irradiation test. To verify the chemical durability of the glasses, several tests such as PCT, ISO, VHT, Soxhlet, MCC-1, and ANS16.1 were carried out. The PCT showed leach rates of B, Na, Li and Si were much less than those of the benchmark glass. The ISO test was performed at 90 degrees C for 1,022 days and Cumulative Fraction Leached of all elements in the glasses were analyzed. According to the VHT, the glasses had an outstanding chemical resistance under humid environment at 200 degrees C for 7 days. The Soxhlet leaching was performed on rectangular glass samples at 98 degrees C for 30 days. To analyze the forward dissolution rates of major glass elements, the MCC-1 was conducted at temperatures of 40, 70, and 90 degrees C for three weeks in pH buffer solutions ranging from pH 4 to 11. The processability of the glasses was in the desired ranges. And the product quality of the glasses met all regulatory guidelines. Using two glasses, the CCIM commissioning tests in the UVF were successfully performed and they showed good workability.
The aim of this study is to examine a relationship between a change in social activity and depression among Koreans aged 45 years or more.
Data came from the Korean Longitudinal Study of Aging (KLoSA) (2006–2010), with 5,327 participants aged 45 years or more. The generalized estimating equation (GEE) with the logit link was used to investigate an association between a change in social activity during 2006–2008 (or 2008–2010) and depression among respondents in year 2008 (or Y2010). Depression was measured by Center for Epidemiological Studies Depression scale (CES-D10) and a change in social activity was classified with four categories, i.e. “consistent participation”, “consistent non-participation”, “participation to non-participation”, and “non-participation to participation”. Social activity was divided into various elements and the same analysis was conducted for each of these elements.
Those with consistent non-participation and from participation to non-participation were more likely to be depressed than those with consistent participation and from non-participation to participation in social activities (OR 1.44 [95% CI 1.22–1.71], OR 1.35 [95% CI 1.15–1.58] vs. OR 1.00 [Reference], OR 1.27 [95% CI 1.09–1.48]). In addition, the strength of the negative association between consistent or new participation in social activity and depression was different across different elements of social activity. The negative association was particularly strong for leisure, culture or sports clubs, and for family or school reunion.
For improving the mental health of the population aged 45 years or more, the promotion of their continued or new participations in leisure/culture clubs and family/school reunion might be needed in South Korea.
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.
This study aimed to investigate the influences of age, education, and gender on the two total scores (TS-I and TS-II) of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological assessment battery (CERAD-NP) and to provide normative information based on an analysis for a large number of elderly persons with a wide range of educational levels.
In the study, 1,987 community-dwelling healthy volunteers (620 males and 1,367 females; 50–90 years of age; and zero to 25 years of education) were included. People with serious neurological, medical, and psychiatric disorders (including dementia) were excluded. All participants underwent the CERAD-NP assessment. TS-I was generated by summing raw scores from the CERAD-NP subtests, excluding Mini-Mental State Examination and Constructional Praxis (CP) recall subtests. TS-II was calculated by adding CP recall score to TS-I.
Both TS-I and TS-II were significantly influenced by demographic variables. Education accounted for the greatest proportion of score variance. Interaction effect between age and gender was found. Based on the results obtained, normative data of the CERAD-NP total scores were stratified by age (six overlapping tables), education (four strata), and gender.
The normative information will be very useful for better interpretation of the CERAD-NP total scores in various clinical and research settings and for comparing individuals’ performance of the battery across countries.
few studies have addressed the association between the characteristics of ischemic lesions detected by diffusion-weighted imaging (dWi) and the clinical outcome in patients with hyperacute posterior circulation ischemic stroke. this study demonstrates a relationship between the findings assessed by dWi and the outcome in patients with hyperacute posterior circulation ischemic stroke.
We reviewed data from 118 patients who had posterior circulation ischemic stroke within six hours from the onset of their symptoms. the clinical outcome included early neurological deterioration (end) and a favorable outcome at three months after the onset of symptoms. using dWi, the lesion volume and the number and location of injured anatomical regions were analyzed to evaluate whether the results correlated with the clinical outcome measures.
the number of injured anatomical regions assessed by dWi was associated with the initial and delayed neurological status. Both the total volume and the number of injured anatomical regions associated with end and a favorable outcome. analysis of the location of the injured regions determined that only a pontine lesion independently associated with end. interestingly, four out of five patients who underwent decompressive craniectomy exhibited a large infarction volume but minor symptoms.
in patients with hyperacute posterior circulation ischemic strokes, the lesions assessed by dWi were associated with the clinical outcome, regardless of the initial neurological status. dWi is an effective initial imaging tool for assessing the extent of lesions and clinical outcomes in patients with hyperacute posterior circulation ischemic stroke.
The detailed knowledge of the three-dimensional (3D) organization of the nervous tissue provides essential information on its functional elucidation. We used serial block-face scanning electron microscopy with focused ion beam (FIB) milling to reveal 3D morphologies of the mossy fiber rosettes in the mice cerebellum. Three-week-old C57 black mice were perfused with a fixative of 1% paraformaldehyde/1% glutaraldehyde in phosphate buffer; the cerebellum was osmicated and embedded in the Araldite. The block containing granule cell layer was sliced with FIB and observed by field-emission scanning electron microscopy. The contrast of backscattered electron image of the block-face was similar to that of transmission electron microscopy and processed using 3D visualization software for further analysis. The mossy fiber rosettes on each image were segmented and rendered to visualize the 3D model. The complete 3D characters of the mossy fiber rosette could be browsed on the A-Works, in-house software, and some preliminary quantitative data on synapse of the rosette could be extracted from these models. Thanks to the development of two-beam imaging and optimized software, we could get 3D information on cerebellar mossy fiber rosettes with ease and speedily, which would be an additive choice to explore 3D structures of the nervous systems and their networks.
Leaf stomatal characteristics of Siberian elm (Ulmus pumila) were investigated by electron microscopy and white light scanning interferometry. On the basis of average annual precipitations, two types of tree specimens were collected from Korea, China, and Mongolia: (1) trees under normal environmental conditions and (2) trees under arid conditions. Field emission scanning electron microscopy revealed oval-shaped stomata on the lower surface, and they were ca. 20 μm in width. In-lens secondary electron imaging showed differences in electron density and stomatal pore depth between the two types. According to the line profile analysis by white light scanning interferometry, stomata under arid conditions appeared to have higher levels of the stomatal pore depth than ones under normal conditions. Focused ion beam–field emission electron microscopy supported the increased stomatal pore depth with the increasing drought stress gradient. These results suggest that complementary microscopy can be employed to unravel the adaptive phenotypic plasticity of Siberian elm in response to drought stress.
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.