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We evaluated the adequacy of microbiological tests in patients withholding or withdrawing life-sustaining treatment (WLST) at the end stage of life.
The study was conducted at 2 tertiary-care referral hospitals in Daegu, Republic of Korea.
Retrospective cross-sectional study.
Demographic findings, clinical and epidemiological characteristics, statistics of microbiological tests, and microbial species isolated from patients within 2 weeks before death were collected in 2 tertiary-care referral hospitals from January to December 2018. We also reviewed the antimicrobial treatment that was given within 3 days of microbiological testing in patients on WLST.
Of the 1,187 hospitalized patients included, 905 patients (76.2%) had WLST. The number of tests per 1,000 patient days was higher after WLST than before WLST (242.0 vs 202.4). Among the category of microbiological tests, blood cultures were performed most frequently, and their numbers per 1,000 patient days before and after WLST were 95.9 and 99.0, respectively. The positive rates of blood culture before and after WLST were 17.2% and 18.0%, respectively. Candida spp. were the most common microbiological species in sputum (17.4%) and urine (48.2%), and Acinetobacter spp. were the most common in blood culture (17.3%). After WLST determination, 70.5% of microbiological tests did not lead to a change in antibiotic use.
Many unnecessary microbiological tests are being performed in patients with WLST within 2 weeks of death. Microbiological testing should be performed carefully and in accordance with the patient’s treatment goals.
In South Korea, many individuals were self-quarantined for the coronavirus disease 2019 (COVID-19) after the quarantine criteria were extended to all overseas travelers. This study was conducted to identify the noncompliance rate of self-quarantine for COVID-19 cases and assess the impact of a 1-strike out policy and an increased amount of penalty for the violating self-quarantine in South Korea.
The self-quarantine noncompliance rate for COVID-19 was examined using publicly available data. We collected the daily number of quarantine and quarantine violation cases from March 22 to June 10, 2020. A Poisson regression analysis was conducted to identify the impact of additional sanctions for the quarantine violation.
The median number of individuals quarantined per day was 36,561 (interquartile range, 34,408-41,961). The median number of daily self-quarantine violations was 6 (range, 0-13). The median rate of self-quarantine violations was 1.6 per 10,000 self-quarantined individuals (range, 0.0-8.0 per 10,000 self-quarantined individuals). The additional sanction has no significant impact on the number of violations among quarantine individuals (P = 0.99).
The additional sanction for the violation of quarantined individuals did not reduce the self-quarantine violations. Further studies are warranted to strengthen the compliance of self-quarantine for future pandemics.
Devastating disasters around the world directly contribute to significant increases in human mortality and economic costs. The objective of this study was to examine the current state of the Korea Disaster Relief Team that participated in an international training module.
The whole training period was videotaped in order to observe and evaluate the respondents. The survey was carried out after completion of the 3-day training, and the scores were reported by use of a 5-point Likert scale.
A total of 43 respondents were interviewed for the survey, and the results showed that the overall preparedness score for international disasters was 3.4±1.6 (mean±SD). The awareness of the Incident Command System for international disasters was shown to be low (3.5±1.1). Higher scores were given to personnel who took on leadership roles in the team and who answered “I knew my duty” (4.4±0.6) in the survey, as well as to the training participants who answered “I clearly knew my duty” (4.5±0.5).
The preparedness level of the Korea Disaster Relief Team was shown to be insufficient, whereas understanding of the roles of leaders and training participants in the rescue team was found to be high. It is assumed that the preparedness level for disaster relief must be improved through continued training. (Disaster Med Public Health Preparedness. 2016;1–5)
The Healthy Twin Study, Korea (HT) is an ongoing multi-center cohort study that was initiated in 2005, based on a nation-wide twin and family database. Since its inception, the HT has recruited 815 pairs of adult twins and a total of 3,690 individual twins and their families as of July 2012. Here we summarize updates since the previous report in 2006. Besides the increase in size, the HT has been enriched in several aspects: a biobank was constructed for ongoing and future omics studies; and genome-wide single nucleotide polymorphism markers (Affymetrix GeneChip version 6.0, 1 M probes) have been analyzed for 2,200 individuals, which enabled gene identification studies for measured phenotypes. In addition, longitudinal study protocols were established through the HT and a second wave survey was finished in 2010 with >70% follow-up rate. The parallel genome research projects were recently launched, which would expedite multi-omics studies maximizing the twin potentials such as metagenomics and epigenetics studies, and endow us with resources for recruiting more participants. We submit this report to share updates and research opportunities from the HT.
Pb is released from bone stores during pregnancy, which constitutes a period of increased bone resorption. A high Na intake has been found to be negatively associated with Ca and adversely associated with bone metabolism. It is possible that a high Na intake during pregnancy increases the blood Pb concentration; however, no previous study has reported on the relationship between Na intake and blood Pb concentration. We thus have investigated this relationship between Na intake and blood Pb concentrations, and examined whether this relationship differs with Ca intake in pregnant Korean women. Blood Pb concentrations were analysed in 1090 pregnant women at mid-pregnancy. Dietary intakes during mid-pregnancy were estimated by a 24 h recall method covering the use of dietary supplements. Blood Pb concentrations in whole-blood samples were analysed using graphite furnace atomic absorption spectrophotometry. Multiple regression analysis performed after adjustment for covariates revealed that maternal Na intake was positively associated with blood Pb concentration during pregnancy, but only when Ca intake was below the estimated average requirement for pregnant Korean women (P= 0·001). The findings of the present study suggest that blood Pb concentration during pregnancy could be minimised by dietary recommendations that include decreased Na and increased Ca intakes.
Zn is an essential element for human growth. The nutritional adequacy of dietary Zn depends not only on the total Zn intake, but also on the type of food source (i.e. of plant or animal origin). We investigated the association between maternal dietary Zn intake from animal and plant food sources and fetal growth. A total of 918 pregnant women at 12–28 weeks of gestation were selected from the Mothers and Children's Environmental Health study in Korea. Dietary intakes in mid-pregnancy were estimated by a 24 h recall method, and subsequent birth weight and height were obtained from medical records. Multiple regression analysis showed that maternal Zn intake from animal food sources and their proportions relative to total Zn intake were positively associated with birth weight (P = 0·034 and 0·045, respectively) and height (P = 0·020 and 0·032, respectively). Conversely, the percentage of Zn intake from plant food sources relative to total Zn intake was negatively associated with birth height (P = 0·026) after adjustment for covariates that may affect fetal growth. The molar ratio of phytate:Zn was negatively associated with birth weight (P = 0·037). In conclusion, we found that the absolute amounts of Zn from different food sources (e.g. animal or plant) and their proportions relative to total Zn intake were significantly associated with birth weight and height. A sufficient amount of Zn intake from animal food sources of a relatively higher Zn bioavailability is thus encouraged for women during pregnancy.
Anthropogenic land use within watersheds has substantial effects on aquatic habitats and biological communities. From September 2006 to December 2008, we investigated the effects of land use on benthic macroinvertebrate communities by comparing Song Stream and Odae Stream, two adjacent mountain streams in Korea whose watersheds have different land use patterns. Song Stream is significantly disturbed by agricultural activities in the watershed, whereas Odae Stream is relatively undisturbed and is surrounded by a well-conserved forest area. Song Stream had significantly higher levels of all nutrients and sediment-related factors due to the adjacent agricultural area. As a result, Song Stream had markedly lower species community indices, such as taxa richness and abundance. In Song Stream, macroinvertebrate scrapers and predators were most adversely affected, whereas collector-gatherers became a dominant group. Based on correlation and multivariate analyses, total dissolved solids had the strongest negative relationship with macroinvertebrate assemblages, followed by electrical conductivity, total nitrogen, and pH. The proportion of cobble in stream substrate was positively related to the richness and abundance of macroinvertebrates. Our results indicate that disturbances caused by agricultural land use, particularly sand deposition, had significant adverse effects on macroinvertebrate habitats and on the biotic integrity of benthic macroinvertebrate communities.
Despite numerous previous studies, relationships between watershed land use and adjacent streams and rivers at various scales in Korea remain unclear. This study investigated the relationships between land uses and the physical, chemical, and biological characteristics of 720 sites of streams and rivers across the country. The land uses at two spatial scales, including a 1-km buffer and the base watershed management region (BWMR), were computed in a geographical information system (GIS) with a digital land use/land cover map. Characteristics of land uses at two spatial scales were then correlated with the monitored multidimensional characteristics of the streams and rivers. The results of this study indicate that land use types have significant effects on stream and river characteristics. Specifically, most characteristics were negatively correlated with the proportions of urban, rice paddy, agricultural, and bare soil areas and positively correlated with the amount of forest. The site-scale and BWMR-scale analyses suggest that BWMR land use patterns were more strongly related to ecological integrity than they were to site land use patterns. Improving our understanding of land use effects will largely depend on relating the results of site-specific studies that use similar response techniques and measures to evaluate ecological integrity. In addition, our results clearly indicate that the characteristics of streams and rivers are closely linked and that land use types differentially affect those characteristics. Thus, effective restoration and management for ecological integrity of lotic system should consider the physical, chemical, and biological factors in combination.
The globular cluster system in M31 is an ideal laboratory for studying the formation and evolution of M31 as well as the globular clusters themselves. There have been numerous surveys and studies of the globular clusters in M31. However, only recently has the entire body of M31 been searched for globular clusters using wide-field CCD images by our group. A new era for the M31 globular cluster system has begun with the advent of wide-field CCD surveys of M31. We have discovered more than 100 new globular clusters in M31. Our catalog currently includes more than 500 globular clusters confirmed either based on spectra or HST images, many more than in the Milky Way. We present the structure, kinematics and chemical abundance of the M31 globular cluster system based on this large sample, and the implications for the formation and evolution of M31.
We report the discovery of three new star clusters in the halo of the Local Group dwarf irregular galaxy NGC 6822. These clusters were found in the deep images taken with the MegaPrime at the CFHT covering a total field of 2 deg $\times$ 2 deg. The most remote cluster is found to be located as far as 79 arcmin away from the center of NGC 6822. This distance is several times larger than the size of the region in NGC 6822 where star clusters were previously found. Morphological structures of the clusters and color-magnitude diagrams of the resolved stars in the clusters show that at least two of these clusters are proabably old globular clusters.
Pt/Ti/SiO2/Si substrates seeded by SBT nanoparticles (∼60–80 nm) were used to enhance the phase formation kinetics of Sr0.7Bi2.4Ta2O9 (SBT) thin films. The volume fractions of Aurivillius phase formation obtained through quantitative x-ray diffraction (Q-XRD) analyses showed highly enhanced kinetics in seeded SBT thin films. The Avrami exponents were determined as ∼1.4 and ∼0.9 for unseeded and seeded SBT films, respectively, which reveals different nucleation modes. By using Arrhenius–type plots the activation energy values for the phase transformation of unseeded and seeded SBT thin films were determined to be ∼264 and ∼168 kJ/mol, respectively. This gives a key reason to the enhanced kinetics in seeded films. Microstructural analyses on unseeded SBT thin films showed formation of randomly oriented needle-like crystals, while those on seeded ones showed formation of domains comprised of directionally grown worm-like crystals.
Sr0.7Bi2.4Ta2O9 (SBT) thin films were deposited on Pt/Ti/SiO2/Si substrates with and without a seed layer of ∼40 nm thickness using sol-gel and spin coating methods. The influence of seed layer on the phase formation characteristics of SBT thin films was investigated using x-ray diffraction (XRD) and scanning electron microscopy (SEM) analyses. Formation of pyrochlore as well as Aurivillius phase was observed in both the unseeded and seeded SBT films heated at 740°C. However, it was revealed that Aurivillius phase formation was enhanced in seeded SBT thin films and pyrochlore phase formation was highly suppressed. In this study, two possible mechanisms for the suppression of pyrochlore phase formation were proposed from the perspectives of activation energy difference for Aurivillius and pyrochlore phase formation and Bi-ion diffusion to pyrochlore phase.
Strontium bismuth tantalate (SBT) having composition of Sr0.7Bi2.4Ta2O9 has been prepared through sol-gel method using their corresponding metal alkoxides as precursors. Seeded SBT powder was prepared by the addition of 5 wt.% of nanometer sized SBT particles to the sol followed by pyrolysis. By applying non-isothermal kinetic analysis to the DTA results, activation energy values for the unseeded and seeded samples were determined. Enhanced crystallization kinetics was observed for the seeded one and the activation energy for the aurivillius phase formation was found to be 318 kJ/mol, while 375 kJ/mol for the unseeded. The Avrami exponent values for the seeded and unseeded were found to be 2.80 and 0.96 respectively.
The crystallization kinetics of SBT and SBT-BTT thin films formed by sol-gel technique on Pt substrate was studied. Phase formation and crystal growth are greatly affected by the film composition and crystallization temperature. Isothermal kinetics analysis was performed on x-ray diffraction (XRD) patterns of the thin films heated in the range 730 to 760° at 10° intervals. Activation energy and Avrami exponent values were determined for the fluorite to Aurivillus phase formation. A reduction of ∼55 kJ/mol in activation is observed for the SBT-BTT system. A comparison has been made and the possible crystallization mechanism is discussed.
We have studied the depositions of amorphous silicon, silicon carbon alloy, doped microcrystalline silicon in order to apply these films as the component materials for the p-i-n and double stacked solar cells. We have obtained low band gap a-Si:H by decreasing the deposition rate under the proper preparation conditions and highly conductive, thin microcrystalline Si and SiC layers. We have developed a stable a-Si/a-Si double stacked solar cell with a conversion efficiency of ∼ % using narrow band gap a-Si:H as a i-layer of bottom cell.The performance of this cell does not degrade until 100 hrs illumination under 350 mW/cm2.
We have studied the improvement of the quality of undoped a-Si:H deposited by remote-plasma chemical vapour deposition. The effects of reactant gas concentration, rf power, substrate bias voltage on the electrical and optical properties have been investigated. Some hydrogen dilution of si lane improves the photoeletric property and a high rf power gives rise to the defect creation due to the ion bombardment on the growing surface. The positive substrate bias improves the quality of undoped a-Si:H.
The effects of deposition temperature, rf power and hydrogen dilution ratio on the growth, structure and transport of p-type microcrystal(μc-) Si films deposited by remote plasma CVD have been investigated. While low substrate temperature and low rf power yield small grain sizes, high temperature and high rf power tend to supress the growth of grains. The etching of Si by hydrogen radicals plays an important role to grow μc-Si, but excess etching supresses the growth of crystallites. We obtained 400 A of grain size and 3.5 S/cm of room temperature conductivity for p-type μ-Si.
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