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Body mass index z-score (BMIz) based on the CDC growth charts is widely used, but it is inaccurate above the 97th percentile. We explored the performance of alternative metrics based on the absolute distance or % distance of a child’s BMI from the median BMI for sex and age.
We used longitudinal data from 5628 children who were first examined < 12 y to compare the tracking of three BMI metrics: distance from median, % distance from median, and % distance from median on a log scale. We also explored the effects of adjusting these metrics for age differences in the distribution of BMI. The intra-class correlation coefficient (ICC) was used to compare tracking of the metrics.
Global inequity in access to and availability of essential mental health services is well recognized. The mental health treatment gap is approximately 50% in all countries, with up to 90% of people in the lowest-income countries lacking access to required mental health services. Increased investment in global mental health (GMH) has increased innovation in mental health service delivery in LMICs. Situational analyses in areas where mental health services and systems are poorly developed and resourced are essential when planning for research and implementation, however, little guidance is available to inform methodological approaches to conducting these types of studies. This scoping review provides an analysis of methodological approaches to situational analysis in GMH, including an assessment of the extent to which situational analyses include equity in study designs. It is intended as a resource that identifies current gaps and areas for future development in GMH. Formative research, including situational analysis, is an essential first step in conducting robust implementation research, an essential area of study in GMH that will help to promote improved availability of, access to and reach of mental health services for people living with mental illness in low- and middle-income countries (LMICs). While strong leadership in this field exists, there remain significant opportunities for enhanced research representing different LMICs and regions.
The relationship between temperature and time required for collagenization using modern bone samples was investigated. Gelatinized samples of bone collagen were filtered to selectively collect different molecular weight fractions. The results of this study suggest that heating to 70 ° for a duration of 12 hr provides the optimal conditions for gelatinization.
The development of radiocarbon dating for degraded bone samples collected at Korean archaeological sites has been successful through the characterization of raw bone C/N ratios and application of an ultrafiltration method. It was found that the C/N ratios of raw bone samples are inversely proportional to the carbon content and residue amount after gelatinization. We have examined a few dozen Korean archaeological bone samples for this study. Well-preserved bone samples are found to be physically dense. The range of C/N ratios of Korean raw bone samples ranged from 3.4 to 74. We found that the C/N ratios of degraded raw bone samples can be used to determine whether 14C samples are acceptable for normal pretreatment processing and eventual dating. The results of this study support that even if the C/N ratio of a degraded raw bone sample is 11, extraction of collagen for bone dating is feasible by a carefully designed ultrafiltration process. Our preliminary 14C dating results of a depth profile of Gunang-gul Cave, an archaeological site in Danyang, Korea, indicate that this site has been either geologically or anthropologically disturbed in the past, with 14C ages ranging from 28,910 ± 200 to 48,090 ± 1050 yr BP. The C/N ratios of the collagen samples of Gunang-gul were determined to be 3.2–3.6. Our study establishes a new guide for the pretreatment of degraded bone samples such as those collected in Korea for 14C dating.
Since iron artifacts generally contain trace amounts of carbon, an iron sample needs to be relatively large, as compared to other materials, and a specially designed combustion system is required. An elemental analyzer (EA) was used for the combustion of iron without any special chemical treatment. CO2 gas with 1 mg of carbon was obtained from the combustion of an iron artifact by using an EA and reduced to graphite for accelerator mass spectrometry (AMS) measurement. In this work, AMS dating results done at the Korea Institute of Geoscience and Mineral Resources (KIGAM) for several ancient iron artifacts are presented and compared with independently estimated ages. This method was found to be useful for the pretreatment of iron artifacts that contained >0.1% carbon. A simple pretreatment method using an EA was also applied to calcium carbonate (CaCO3) samples. Samples were preheated overnight at 100–300 °C, without any special chemical treatment. This removed modern CO2 contamination and the background level decreased to a comparable value measured in samples treated with phosphoric acid under vacuum.
Introduction: Point of care ultrasound has become an established tool in the initial management of patients with undifferentiated hypotension. Current established protocols (RUSH, ACES, etc) were developed by expert user opinion, rather than objective, prospective data. We wished to use reported disease incidence to develop an informed approach to PoCUS in hypotension using a “4 F’s” approach: Fluid; Form; Function; Filling. Methods: We summarized the incidence of PoCUS findings from an international multicentre RCT, and using a modified Delphi approach incorporating this data we obtained the input of 24 international experts associated with five professional organizations led by the International Federation of Emergency Medicine. The modified Delphi tool was developed to reach an international consensus on how to integrate PoCUS for hypotensive emergency department patients. Results: Rates of abnormal PoCUS findings from 151 patients with undifferentiated hypotension included left ventricular dynamic changes (43%), IVC abnormalities (27%), pericardial effusion (16%), and pleural fluid (8%). Abdominal pathology was rare (fluid 5%, AAA 2%). After two rounds of the survey, using majority consensus, agreement was reached on a SHoC-hypotension protocol comprising: A. Core: 1. Cardiac views (Sub-xiphoid and parasternal windows for pericardial fluid, cardiac form and ventricular function); 2. Lung views for pleural fluid and B-lines for filling status; and 3. IVC views for filling status; B. Supplementary: Additional cardiac views; and C. Additional views (when indicated) including peritoneal fluid, aorta, pelvic for IUP, and proximal leg veins for DVT. Conclusion: An international consensus process based on prospectively collected disease incidence has led to a proposed SHoC-hypotension PoCUS protocol comprising a stepwise clinical-indication based approach of Core, Supplementary and Additional PoCUS views.
Introduction: Point of care ultrasound (PoCUS) provides invaluable information during resuscitation efforts in cardiac arrest by determining presence/absence of cardiac activity and identifying reversible causes such as pericardial tamponade. There is no agreed guideline on how to safely and effectively incorporate PoCUS into the advanced cardiac life support (ACLS) algorithm. We consider that a consensus-based priority checklist using a “4 F’s” approach (Fluid; Form; Function; Filling), would provide a better algorithm during ACLS. Methods: The ultrasound subcommittee of the Australasian College for Emergency Medicine (ACEM) drafted a checklist incorporating PoCUS into the ACLS algorithm. This was further developed using the input of 24 international experts associated with five professional organizations led by the International Federation of Emergency Medicine. A modified Delphi tool was developed to reach an international consensus on how to integrate ultrasound into cardiac arrest algorithms for emergency department patients. Results: Consensus was reached following 3 rounds. The agreed protocol focuses on the timing of PoCUS as well as the specific clinical questions. Core cardiac windows performed during the rhythm check pause in chest compressions are the sub-xiphoid and parasternal cardiac views. Either view should be used to detect pericardial fluid, as well as examining ventricular form (e.g. right heart strain) and function, (e.g. asystole versus organized cardiac activity). Supplementary views include lung views (for absent lung sliding in pneumothorax and for pleural fluid), and IVC views for filling. Additional ultrasound applications are for endotracheal tube confirmation, proximal leg veins for DVT, or for sources of blood loss (AAA, peritoneal/pelvic fluid). Conclusion: The authors hope that this process will lead to a consensus-based SHoC-cardiac arrest guideline on incorporating PoCUS into the ACLS algorithm.
Δ14C values of leaves of deciduous trees provide a means to map the regional-scale fossil fuel ratio in the atmosphere. We collected a batch of ginkgo (Ginkgo biloba Linnaeus, a deciduous tree) leaf samples from across Korea in the month of July in both 2010 and 2011 to obtain the regional distribution of Δ14C. The Δ14C values of the samples were measured using accelerator mass spectrometry (AMS) at the Korea Institute of Geoscience and Mineral Resources (KIGAM). The average of the Δ14C values from clean air sites in Korea in 2011 measured slightly lower than the average of Δ14C values in 2010. Distribution maps of Δ14C of 2011 and 2010 in Korea were made based on a series of Δ14C values of ginkgo leaf samples from Korea using the Geostatistical and Spatial analyst tools in ESRI's ArcMap software. The distribution maps of Δ14C showed that Δ14C values in the western part of Korea are lower than those in the eastern part of Korea. This is because the western part of Korea is densely populated and contains many industrial complexes, and also because westerly winds from China, containing CO2 from fossil fuel use, blow into Korea. We compared the distribution maps of 2010 and 2011 and tried to find traces of the Fukushima power plant accident in Japan.
This study aimed to evaluate the efficacy of post-operative voice therapy after phonomicrosurgery for vocal polyp removal.
The study retrospectively enrolled 55 consecutive patients who had undergone voice therapy after phonomicrosurgery for vocal polyp removal occurring between June 2010 and June 2011. A historical group of 63 similar patients not receiving voice therapy was used as an external control. We compared voice analysis parameters and Voice Handicap Index scores for the two groups.
Most objective and subjective voice outcome parameters were significantly improved after surgical treatment. Although the study and control groups showed no significant difference regarding objective parameters (using acoustic and aerodynamic analysis) or the subjective parameters assessed using the grade-roughness-breathiness-asthenia-strain scale, the study group had significantly better final Voice Handicap Index scores.
Following surgery for vocal polyps, post-operative voice therapy can improve patients' vocal discomfort, emotional responses and everyday self-perception.
We investigated the connection between AGN and star formation (SF) activities of various kinds of AGNs and their host galaxies. In order to probe SF activity, we measured the 3.3 μm PAH emission luminosity utilizing the slitless spectroscopic capability of AKARI space telescope. We present the results from two missions, ASCSG and LQSONG.
Abstract:GaN thin films on sapphire were grown by RF magnetron sputtering with ZnO buffer layer. The tremendous mismatch between the lattices of GaN and sapphire can be partly overcome by the use of thin buffer layer of ZnO. The dependence of GaN film quality on ZnO buffer layer was investigated by X-ray diffraction(XRD). The properties of the sputtered GaN are strongly dependent on ZnO buffer layer thickness. The optimum thickness of ZnO buffer layer is around 30nm. Using XRD analysis, we have found the optimal substrate temperature which can grow high quality GaN thin film. In addition, the effect of excimer laser annealing(ELA) on structural and electrical properties of GaN thin films was investigated. The surface roughness and images according to the laser energy density were investigated by atomic force microscopy(AFM) and it was confirmed that the crystallization was improved by increasing laser energy density.
The relation between the ion irradiation induced grain growth in bilayer system and the basic parameters involved in ion beam mixing process was studied. TEM micrographs showed that a significant grain growth has been induced by Ar+ irradiation at room temperature. The grain size increases rapidly in low dose region, while it approaches a saturated value in high dose region, and it has close relationship with thermodynamic properties such as cohesive energy ( ΔHc ) and heat of mixing( ΔHm ). The experimental results are in good agreement with the model for the grain growth based on the thermal spike induced atomic migration.
The effects of SF6 and NF3 gas plasma treatments, and succesive rapid thermal anneal (RTA) treatment for the recovery of modified silicon surface due to CHF3/C2F6 plasma have been investigated using X-ray photoelectron spectroscopy (XPS) and secondary ion mass spectrometry (SIMS). XPS analyses have revealed that NF3 and SF6 plasma treatments are effective for the removal of residue layer. SIMS results show that penetrated impurities in the contaminated silicon substrate reduce through the additional RTA treatment. The effects of NF3, SF6 plasmas, and additional RTA treatments for the recovery of reactive ion etched silicon surface has been also studied by measuring the electrical performance of the silicon devices.
Reactive ion etching of features down to 100 nm in linewidth in tungsten has been studied using an SF6 based chemistry. The studies were carried out in a PlasmaTherm 500 etcher operated at low pressure (2 mTorr) and power (100 mWatts/cm2). Key processing parameters have been identified to achieve the resolution and aspect ratio required for high contrast x-ray masks. The critical parameters include sample temperature, gas dilution and end point detection. However, even with all of these parameters optimized, additional sidewall passivation is required to obtain the necessary 6.5:1 aspect ratio. A novel method of achieving such passivation based on an intermittent etching process is described.
In order to study atomic transport in the radiation enhanced diffusion (RED) region, Pd/Co bilayers were intermixed by 80keV Ar+ in the temperature range from 90 K to 700 K. The critical temperature for the onset of RED was found to be ∼ 400 K, and the transported amount of Pd atoms was found to be always larger than that of Co in the RED region. This result cannot be explained by pre-existing models. Thus we have developed a comprehensive model for atomic transport in the RED region including size effect, damage controlled effect, and cohesive energy effect.
The optimum processing condition for a photocrosslinking Nonlinear Optical(NLO) polymeric system was established. Parameters such as change in heat capacity at glass transition temperature, rate of decrease of absorbance of residual uncrosslinked chromophores, and measurement of mass loss upon heating were used to set up the optimum condition. Poly(vinyl cinnamate) was used as the photocrosslinkable polymer and 3- cinnamoyloxy-4-[4-(N, N-diethylamino)-2-cinnamoyloxy phenyl azo] nitrobenzene was used as the NLO molecule. Poling at 70°C for 5 minutes followed by photocrosslinking with a dose of 2.5 mW/cm 2 for 10 minutes results in a stable second order nonlinear optical material.