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Major incidents affecting large numbers of people may increase the rate of acute cardiovascular events, even among those who are not directly involved in the incident. It is hypothesized that the MV Sewol ferry disaster (South Korea) would increase the incidence of cardiovascular events nation-wide.
Data on all adult patients (>18 years) who were diagnosed with acute cardiovascular events, including acute myocardial infarction (MI), angina, and cardiac arrhythmias, were extracted from the National Emergency Department Information System (NEDIS) from March 15 through June 17, during the years 2011-2014 (four weeks before to eight weeks after the event date). Poisson regression models were used to calculate the incidence rate ratios (IRRs) comparing the weekly changes in the occurrences of cardiovascular events from the week of the Sewol event (April 16-22, 2014) to eight weeks after the disaster (June 11-17, 2014), using the one-month period before Sewol as a reference period (March 15-April 15), adjusting for calendar years (years 2011-2014) and environmental factors.
During the study periods, cardiovascular events were identified in 73,823 patients. Compared to the reference period, the week of the Sewol disaster and the three weeks after the disaster showed a significant increase in the number of acute cardiovascular events, IRRs of 1.09 (95% CI, 1.03-1.15) and 1.08 (95% CI, 1.02-1.15), respectively (P <.01 for both). In particular, there was 21% increase in incidence of arrhythmia (IRR = 1.21; 95% CI, 1.02-1.44; P = .03) during the week of the Sewol disaster compared with the reference period.
This study showed a significant increase in the incidence of acute cardiovascular events during the week of, and the three weeks after, the Sewol ferry disaster in 2014. These additional cardiac emergencies may be triggered by emotional stressors related to the event, highlighting the public health importance of indirect exposure to a tragic catastrophe.
Kong SY, Song KJ, Shin SD, Ro YS. Cardiovascular events after the Sewol ferry disaster, South Korea. Prehosp Disaster Med. 2019;34(2):142–148
The Sewol ferry disaster is one of the most tragic events in Korea’s modern history. Among the 476 people on board, which included Danwon High School students (324) and teachers (14), 304 passengers died in the disaster (295 recovered corpses and 9 missing) and 172 survived. Of the rescued survivors, 72 were attending Danwon High School, located in Ansan City, and residing in a residence nearby. Because the students were young, emotionally susceptible adolescents, both the government and the parents requested the students be grouped together at a single hospital capable of appropriate psychiatric care. Korea University Ansan Hospital was the logical choice, as the only third-tier university-grade hospital with the necessary faculty and facilities within the residential area of the families of the students. We report the experiences and the lessons learned from the processes of preparing for and managing the surviving young students as a community-based hospital. (Disaster Med Public Health Preparedness. 2017;11:389–393)
To examine the association of food insufficiency with dietary intake and eating and health behaviours.
A cross-sectional study.
Data were obtained from a secondary source, the Fifth Korea National Health and Nutrition Examination Survey (2010–2012).
The sample size consisted of 15 603 adults over 19 years of age (8898 households).
Significant differences in socio-economic factors were observed according to food insufficiency level (P<0·05), but BMI was similar among groups. Regarding macronutrients, lower protein intake and higher carbohydrate intake were found in the severely food-insufficient group, but we found no association with fat intake. Regarding micronutrients, Ca, Fe, vitamin A, thiamin, riboflavin niacin and vitamin C intakes were negatively associated with food insufficiency level (Ptrend<0·05). Consumption of different food groups, such as meat, fish, eggs and beans, vegetables and fruits, was significantly lower as food insufficiency level decreased after controlling for all possible variables; food group consumption also differed by sex. Overall eating and health behaviours were poorer in the mildly and severely food-insufficient groups, who received more food assistance but less nutritional education.
Our results showed that dietary intake as well as eating and health behaviours are adversely associated with food insufficiency. These findings suggest that specific strategies to help food-insufficient individuals should be developed in order to improve their dietary quality and health status.
Genetic factors have been suggested to be one of the determinants of the variation of left ventricular (LV) structure and function. However, the heritability range of LV structure varies across studies and the influence of genetics on LV function is not well established, especially in Asian populations. Study subjects were 1,642 healthy Korean adults from 426 families, consisting of 298 pairs of monozygotic twins, 62 pairs of dizygotic twins, one set of triplets, 567 siblings, and 354 parents. LV structure and function were measured by M-mode and 2D echocardiography, and conventional and tissue Doppler imaging (TDI). Pairwise intra-class correlations for various familial relationships and heritability were estimated for LV structure and function. The heritability of LV mass, LV ejection fraction (LVEF), left atrial volume index, the ratio between early and late diastolic velocity of mitral inflow (E/A ratio), and the ratio between early diastolic velocity of mitral inflow and early diastolic mitral annular velocities (E/Ea ratio) was 0.44, 0.27, 0.44, 0.25, and 0.33, respectively. Bivariate genetic analysis showed that LV structural and functional traits had significant genetic correlations with cardiovascular risk factors. Additive genetic correlation (ρG) of LV mass with body mass index, systolic blood pressure, and high density lipoprotein cholesterol were 0.49, 0.42, and -0.15 respectively. LVEF (ρG = 0.33) and left atrial volume index (ρG = 0.24) also had a significant genetic correlation with systolic blood pressure. These findings support the theory that genetic factors have significant influence on these traits and necessitate further work to identify the specific genes involved.
Despite substantial research, uncertainty remains about the clinical and etiological heterogeneity of major depression (MD). Can meaningful and valid subtypes be identified and would they be stable cross-culturally?
Symptoms at their lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years, with recurrent DSM-IV MD. Latent class analysis (LCA) was performed in Mplus.
Using the nine DSM-IV MD symptomatic A criteria, the 14 disaggregated DSM-IV criteria and all independently assessed depressive symptoms (n = 27), the best LCA model identified respectively three, four and six classes. A severe and non-suicidal class was seen in all solutions, as was a mild/moderate subtype. An atypical class emerged once bidirectional neurovegetative symptoms were included. The non-suicidal class demonstrated low levels of worthlessness/guilt and hopelessness. Patterns of co-morbidity, family history, personality, environmental precipitants, recurrence and body mass index (BMI) differed meaningfully across subtypes, with the atypical class standing out as particularly distinct.
MD is a clinically complex syndrome with several detectable subtypes with distinct clinical and demographic correlates. Three subtypes were most consistently identified in our analyses: severe, atypical and non-suicidal. Severe and atypical MD have been identified in multiple prior studies in samples of European ethnicity. Our non-suicidal subtype, with low levels of guilt and hopelessness, may represent a pathoplastic variant reflecting Chinese cultural influences.
Liposomal drug delivery products have been already commercialized in tumor therapeutics, which can realize passive tumor targeting via enhanced permeability and retention (EPR) effect resulting from the leaky tumor vasculature. To control drug release out of the liposomes, thermo-sensitive liposomes (TSLs) have been developed so that an abrupt exposure of highly concentrated drugs to tumor tissues was enabled by locally treated thermal stimuli. As interests upon TSL have increased along with ongoing clinical trials, some types of TSLs with different physical properties in pharmacokinetics and the mechanism of drug release have been formulated. However, there are few protocols established with a desirable heat source to maximize the efficacy of different TSLs as treating tumors. In this study, we examined different protocols for the most effective application of different TSLs to tumor therapy. First, we examined if enhancing the accumulation of TSLs within tumor tissues prior to bursting drugs out of TSLs could lead to increasing anti-tumor efficacy. Second, we compared the efficiency of two different heat sources on the use of TSL, a warm water bath (42°C) and high intensity focused ultrasound (HIFU). Our study suggests that the specified protocol be setup for TSLs with different physical properties to optimally function in tumor therapies.
The symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome?
Symptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples.
The preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety.
MD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome.
This article discusses the transition of international criminal justice from a predominantly ex post facto punitive concept of post World War II efforts—and the ad hoc tribunals set up in the 1990s—towards a more comprehensive concept of justice centred around the International Criminal Court established by the Rome Statute, with significant potential for the prevention of future atrocities. Four sources of preventive effect are examined: deterrence, timely intervention, stabilization, and norm setting. Significant challenges remain for the Rome Statute system, notably strengthening the principle of complementarity, enhancing the co-operation of states with the ICC, securing sufficient resources for international justice, and furthering universal acceptance of the Rome Statute, especially in the Asia-Pacific. The author argues that the ultimate value of the Rome Statute system lies in entrenching legal and social norms that will help human compassion prevail over cruelty.
To validate a brief FFQ developed for capturing short-term antioxidant intake in a sample of US college students.
A seventy-four-item antioxidant FFQ was developed based on major antioxidant sources in the American diet. The FFQ was validated against 30 d food records (FR) and plasma antioxidant concentrations. The reliability of the FFQ was evaluated by two FFQ administered at a 1-month interval.
University of Connecticut, CT, USA.
Sixty healthy college students.
Estimates of dietary antioxidants from the FFQ were moderately to highly correlated with those estimated from the 30 d FR (r = 0·29–0·80; P < 0·05) except for γ-tocopherol and β-cryptoxanthin. Total antioxidant capacity from diet only or from diet and supplements estimated by the 30 d FR and FFQ were highly correlated (r = 0·67 and 0·71, respectively; P < 0·0001). The FFQ categorized 91 % of participants into the same or adjacent tertiles of antioxidant intake as the 30 d FR. Most dietary carotenoids estimated from the FFQ were correlated with plasma levels (P < 0·05). Correlation coefficients for test–retest reliability ranged from 0·39 to 0·86. More than 94 % of the participants were classified in the same or adjacent tertiles between the two administrations of the FFQ.
The brief FFQ demonstrated reasonable validity for capturing a comprehensive antioxidant intake profile. This FFQ is applicable in epidemiological or clinical studies to capture short-term antioxidant intake or to simply document the variations of antioxidant intake in intervention trials. Cross-validation studies are warranted in other target populations.
A historic achievement of the Review Conference of the Rome Statute of the International Criminal Court held in Kampala in June 2010 was the adoption of amendments to the Rome Statute defining the crime of aggression and how the Court would exercise jurisdiction over this crime. Defining the crime of aggression had been on the international agenda for nearly a century and there was scepticism leading up to the Conference about whether delegates would be able to agree on proposed amendments given their divergent positions on many issues.
This volume chronicles the evolution of the crime of aggression: from its historic roots in 1919 and its promulgation at Nuremburg, to its inclusion in the Rome Statute, the lead-up to the Review Conference and ultimately the adoption of the aggression resolution at Kampala. More importantly, the volume provides a comprehensive account of the negotiating and drafting history of the amendment proposals put before the Review Conference and the subsequent negotiations that took place. The authors are to be commended for compiling the travaux préparatoires into one resource and giving the reader direct and unfettered access to the original sources, which include selected unpublished documents.
To apply the superconducting wire to power machines, it is necessary to conduct research on the characteristics of wire phase changes in connection with insulating layers. In this study, according to the presence or absence of insulating layers in the wire, and to the thickness of such layers, the wire's resistance increase trends and the characteristics of its recovery from quenching were examined by current-applied cycle at the temperatures of 90 K, 180 K and 250 K. Towards this end, YBCO thin-film wires that have the same critical temperatures and that have copper and stainless-steel stabilizing layers were prepared. One level and three and five levels of superior-performance polyimide pressure-sensitive adhesive tape was attached to the wires at a very low temperature. The eight prepared test samples were wound around the linear frames, then the wire's voltage and current created owing to the phase change characteristics were measured at each prescribed temperature, using the four-point probe method. Further, near the examination temperatures of 90 K, 180 K and 250 K the wire's resistance and recovery characteristics were examined by cycle.
This paper compared two different film deposition processes for formation of TiN barrier layers, conventional TiCl4-based chemical vapor deposition and atomic layer deposition (ALD). The 30nm thick TiN film deposited by conventional TiCl4-based CVD at the process temperature of 600°C followed by NH3 post-deposition anneal showed about 180 μΩcm of resistivity, over 95 % of step coverage for the pattern aspect ratio of 6 on 0.35 μm contact diameters, and below 2 at.% of chlorine contents in the film. Meanwhile, the films deposited by ALD at 100°C lower process temperature than CVD showed much better film properties even without post-deposition anneal. It showed lower resistivity values and lower chlorine incorporation along with better step coverage characteristics. More detailed material analysis was done by AFM, SEM, and AES.
To investigate the association of antioxidant intakes from diet and supplements with elevated blood C-reactive protein (CRP) and homocysteine (Hcy) concentrations.
A cross-sectional study. The main exposures were vitamins C and E, carotene, flavonoid and Se intakes from diet and supplements. Elevated blood CRP and Hcy concentrations were the outcome measures.
The US population and its subgroups.
We included 8335 US adults aged ≥19 years from the National Health and Nutrition Examination Survey 1999–2002.
In this US population, the mean serum CRP concentration was 4·14 (95 % CI 3·91, 4·37) mg/l. Intakes of vitamins C and E and carotene were inversely associated with the probability of having serum CRP concentrations >3 mg/l in multivariate logistic regression models. Flavonoid and Se intakes were not associated with the odds of elevated serum CRP concentrations. The mean plasma Hcy concentration was 8·61 (95 % CI 8·48, 8·74) μmol/l. Intakes of vitamins C, E, carotenes and Se were inversely associated with the odds of plasma Hcy concentrations >13 μmol/l after adjusting for covariates. Flavonoid intake was not associated with the chance of elevated plasma Hcy concentrations.
These results suggest that high antioxidant intake is associated with lower blood concentrations of CRP and Hcy. These inverse associations may be among the potential mechanisms for the beneficial effect of antioxidant intake on CVD risk mediators in observational studies.
A pattern specific corrosion of aluminum wires was found during aluminum chemical mechanical polishing process. This paper presents and discusses the particular pattern dependency of the corrosion behavior and effective control methods in order to reduce the corrosion. An aluminum single damascene structure on silicon dioxide thin film was prepared and the effects of process variables and pattern configuration on corrosion behavior were extensively explored. The corrosion behavior was quantitatively analyzed using sheet resistance of corroded line. It was demonstrated that corrosion of aluminum wire was associated with cleaning media and pattern configuration. The area ratio between sub-micron size line and pads was the most important factors to determine the corrosion behavior. A post cleaning chemical including corrosion inhibitor couldn't prevent the corrosion perfectly. It was found that sacrificial dummy lines could reduce the aluminum corrosion, which suggests that the aluminum corrosion could be controlled by the structural consideration in aluminum damascene.
XeCl excimer laser was irradiated on metal induced laterally crystallized (MILC) polycrystalline silicon (poly-Si) film in order to eliminate the intra-grain defects of MILC poly-Si film which incorporated 2 μm wide metal induced crystallized (MIC) poly-Si line pattern. On the irradiation of the laser beams, different melt and recrystallization phenomena were observed in the MILC and the MIC poly-Si region due to the Ni content difference in each film. The transmission electron microscopy (TEM) and secondary ion mass spectrometry (SIMS) measurements indicated that the melting temperature of the poly-Si film decreased as the Ni content increased. With the laser irradiation energy density of 370 mJ/cm2, 2 μm long defect-free poly-Si grain was successfully grown in the MILC poly-Si due to the melting temperature variation at the MILC-MIC poly-Si boundary.
We have proposed and fabricated a novel poly-Si TFT that is integrated into the gate-data line-crossover in order to increase aperture ratio and to decrease signal delay of AMLCD panel and electrical characteristics of TFT integrated into gate-data line-crossover almost are identical to conventional TFT. The aperture ratio of AMLCD panel was increased considerably because the TFT was located under the opaque metal line. We employed a low dielectric air-gap between the gate-data line crossover, which reduced a capacitance between the gate and data lines so that the RC signal delay of the data line is decreased significantly. Our experimental result shows that the fabricated TFT was successfully operated and the proposed structure found to reduce the RC signal delay has been reduced by factor of 9 compared with conventional AMLCD panel that employs SiO2 for insulator between gate and data lines.
Metal organic deposition (MOD) is one of the attractive processes for coated conductor applications because it is a non-vacuum cost-effective process. Many research groups have successfully fabricated high-JC YBCO coated conductor on the RABiTS and IBAD-YSZ or GZO template with the MOD process. Reports on MOD-processed YBCO coated conductors prepared on the IBAD-MgO template, however, are hardly found. The precursor solution was coated on the CeO2 capped IBAD-MgO template using the slot-die coating method, calcined at a temperature of 550oC, and fired at high temperatures for 2 h 30 min in a reduced oxygen atmosphere. Optimal processing resulted in YBCO coated conductors exhibiting JC value of 0.75 MA/cm2 at 77 K in self-field. The JC values of YBCO coated conductors were found very sensitive to their microstructure, critical temperature, and in-plane texture.
In the scribe lane, which is located at the frame neighboring two chips, most of the test patterns for monitoring electrical characteristics of memory device as well as various key patterns for photo process are formed. The pattern density of these regions is lower than that of the main chip area, and cause nitride erosion by dishing phenomena during HSS STI CMP process. Nitride erosion occurred in the scribe lane region, could the affect erosion properties of cell region in main chip area, results in within die remain nitride variation and marginal fail in device operation. In this work, in order to prevent these problems, pattern design in the scribe lane was modified so as not to occurs within die remain nitride variation. The effects of improvement in within die remain nitride variation were investigated by FIB-TEM analysis and its correlation with electrical properties were explained.