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To investigate the impacts of depression screening, diagnosis and treatment on major adverse cardiac events (MACEs) in acute coronary syndrome (ACS).
Prospective cohort study including a nested 24-week randomised clinical trial for treating depression was performed with 5–12 years after the index ACS. A total of 1152 patients recently hospitalised with ACS were recruited from 2006 to 2012, and were divided by depression screening and diagnosis at baseline and 24-week treatment allocation into five groups: 651 screening negative (N), 55 screening positive but no depressive disorder (S), 149 depressive disorder randomised to escitalopram (E), 151 depressive disorder randomised to placebo (P) and 146 depressive disorder receiving medical treatment only (M).
Cumulative MACE incidences over a median 8.4-year follow-up period were 29.6% in N, 43.6% in S, 40.9% in E, 53.6% in P and 59.6% in M. Compared to N, screening positive was associated with higher incidence of MACE [adjusted hazards ratio 2.15 (95% confidence interval 1.63–2.83)]. No differences were found between screening positive with and without a formal depressive disorder diagnosis. Of those screening positive, E was associated with a lower incidence of MACE than P and M. M had the worst outcomes even compared to P, despite significantly milder depressive symptoms at baseline.
Routine depression screening in patients with recent ACS and subsequent appropriate treatment of depression could improve long-term cardiac outcomes.
To overcome the limited feasibility of various refractory high-entropy alloys (HEAs) due to the presence of (i) very dense elements (W and Ta), (ii) costly elements (Hf and Ta), and (iii) oxidation prone elements (V) in them, AlxCryMozNbTiZr HEAs were prepared via arc-melting. Considering the critical nature of oxidation resistance in high-temperature applications, HEAs were characterized to form a combinatorial library of microstructural and oxidation behavior. AlxCryMozNbTiZr HEAs revealed multiphase microstructures consisting of intermetallic phases along with BCC matrices. Mass loss and porous microstructures were obtained in Mo-rich HEAs after oxidation at 1000 °C for 1 h. The presence of Al enhanced the oxidation resistance and developed a protective oxide layer on the HEAs. Al30Cr10-NTZ exhibited promising potential for use in high temperature applications, as it showed an oxidation time exponent of ∼0.5 and a dense and continuous oxide layer.
Stable carbon isotope ratios were measured on the alpha-cellulose in tree rings of a pine tree (Pinus densiflora) from Yeongwol, Korea. We developed an annual-resolution δ13C series (1835–1905) by correcting the measured data for changes in δ13C of air to minimize non-climatic influences. To investigate the climatic signal in the δ13C series, we performed correlation analysis between δ13C and the Cheugugi climate data. The Cheugugi precipitation data were first recorded by King Sejong (1397–1450) of the Joseon Dynasty. However, the longest set of precipitation data available is the one collected in Seoul (1776–1907). Although many studies support the reliability of the Cheugugi data, no previous studies have investigated the potential of the δ13C signal in tree rings as paleoclimate proxy using the Cheugugi data. Recent precipitation trends in Yeongwol are quite similar to that of Seoul, and we found significant correlations between the Cheugugi data and the δ13C series. We suggest further studies to replicate these results and confirm whether comparing δ13C variations in tree rings and Cheugugi data is a useful method of investigating the potential of the δ13C signal as a paleoclimate proxy in or near the Korean peninsula.
The National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute neuropsychology protocol consists of only verbal tasks, and is proposed as a brief screening method for vascular cognitive impairment. We evaluated its feasibility within two weeks after stroke and ability to predict the development of post-stroke dementia (PSD) at 3 months after stroke.
We prospectively enrolled subjects with ischemic stroke within seven days of symptom onset who were consecutively admitted to 12 university hospitals. Neuropsychological assessments using the NINDS-CSN 5-minute and 60-minute neuropsychology protocols were administered within two weeks and at 3 months after stroke onset, respectively. PSD was diagnosed with reference to the American Heart Association/American Stroke Association statement, requiring deficits in at least two cognitive domains.
Of 620 patients, 512 (82.6%) were feasible for the NINDS-CSN 5-minute protocol within two weeks after stroke. The incidence of PSD was 16.2% in 308 subjects who had completed follow-up at 3 months after stroke onset. The total score of the NINDS-CSN 5-minute protocol differed significantly between those with and without PSD (4.0 ± 2.7, 7.4 ± 2.7, respectively; p < 0.01). A cut-off value of 6/7 showed reasonable discriminative power (sensitivity 0.82, specificity 0.67, AUC 0.74). The NINDS-CSN 5-minute protocol score was a significant predictor for PSD (adjusted odds ratio 6.32, 95% CI 2.65–15.05).
The NINDS-CSN 5-minute protocol is feasible to evaluate cognitive functions in patients with acute ischemic stroke. It might be a useful screening method for early identification of high-risk groups for PSD.
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.
Feasibility of multiwavelength Raman spectroscopy was studied as a potential
in-line monitoring technique for grain size distribution in channel poly-Si used
in three dimensional stacked NAND (3D NAND) Flash memory devices. Various
channel poly-Si materials in 3D-NAND Flash memory devices, converted from
chemical vapor deposition (CVD) grown a-Si, were characterized using
non-contact, multiwavelength Raman spectroscopy and high resolution
cross-sectional transmission electron microscopy (HRXTEM). The Raman
characterization results were compared with HRXTEM images. The correlation
between the grain size distribution characterized by multiwavelength Raman
spectroscopy and “on current” (ION) of 3D NAND
Flash memory devices was investigated. Good correlation between these techniques
was seen. Multiwavelength Raman spectroscopy is very promising as a
non-destructive in-line monitoring technique for grain size distribution in
channel poly-Si used in 3D NAND Flash memory devices.
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.
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.
Octamer-binding transcription factor 4 (Oct4) is a critical molecule for the self-renewal and pluripotency of embryonic stem cells. Recent reports have shown that Oct4 also controls cell-cycle progression and enhances the proliferation of various types of cells. As the high proliferation of donor fibroblasts is critical to the production of transgenic pigs, using the somatic cell nuclear transfer technique, we analysed the effect of Oct4 overexpression on the proliferation of porcine fibroblasts and embryos. Porcine endogenous Oct4 cDNA was cloned, sequenced and inserted into an expression vector. The vector was transfected into porcine fibroblasts, and a stable Oct4-overexpressed cell line was established by antibiotic selection. Oct4 expression was validated by the immunostaining of Oct4. Cell morphology was changed to sharp, and both proliferation and migration abilities were enhanced in Oct4-overexpressed cells. Real-time RT-PCR results showed that p16, Bcl2 and Myc were upregulated in Oct4-overexpressed cells. Somatic cell nuclear transfer was performed using Oct4-overexpressed cells, and the development of Oct4 embryos was compared with that of wild-type cloned embryos. The cleavage and blastocyst formation rates were improved in the Oct4 embryos. Interestingly, blastocyst formation of the Oct4 embryos was observed as early as day 5 in culture, while blastocysts were observed from day 6 in wild-type cloned embryos. In conclusion, the overexpression of Oct4 enhanced the proliferation of both porcine fibroblasts and embryos.
A compact subthreshold characteristics model for short channel fully-depleted double-gate (DG) junctionless field effect transistors (JL FETs) which is based on an approximated solution of 2 dimensional Poisson’s equation has been proposed. The derivation details are introduced and the model’s accuracy has been verified by comparison with both previous models and the TCAD simulations’ results which proves that the subthreshold characteristics such as channel potential distribution, subthrethold drain-to-source current, subthreshold slope, drain-induced-barrier-lowering and threshold voltage can be accurately predicted by our proposed compact model.
To investigate whether low vitamin D status was related to insulin resistance (IR) or impaired fasting glucose (IFG) in Korean adolescents, after adjusting for total body fat mass (FM).
A cross-sectional study.
Korea National Health and Nutrition Examination Survey (KNAHNES) 2009–2010.
In total, 1466 participants (769 males) aged 10–19 years were assessed for serum 25-hydroxyvitamin D (25(OH)D) levels, for FM by whole-body dual-energy X-ray absorptiometry and for IR by homeostasis model assessment (HOMA-IR) after an 8 h fast.
Age-, sex-, season- and physical-activity-adjusted regression models showed that serum 25(OH)D levels were significantly related to markers of adiposity (P = 0·016 for FM (g), P = 0·023 for FM (%) and P = 0·035 for fat mass index). When the participants were stratified into three 25(OH)D categories (<37·5 nmol/l (n 553), 37·5 to < 50 nmol/l (n 543) and ≥ 50 nmol/l (n 370)), significantly decreasing trends were observed for fasting insulin (all P < 0·001), HOMA-IR (all P < 0·001) and the odds ratios for IFG (all P for trend < 0·05) from the lowest to the highest 25(OH)D category, after adjustments for age, sex, physical activity and all markers of adiposity. In the multivariate logistic regression analysis, the likelihood of participants in the lowest serum 25(OH)D category having IFG was 2·96–3·15 compared with those in the highest 25(OH)D category (all P < 0·05).
There was a significant inverse relationship between vitamin D status and IR and the risk of IFG, independent of adiposity, in Korean adolescents.
Distribution of wax in laser printer toner was observed using an ultra-high-voltage (UHV) and a medium-voltage transmission electron microscope (TEM). As the radius of the wax spans a hundred to greater than a thousand nanometers, its three-dimensional recognition via TEM requires large depth of focus (DOF) for a volumetric specimen. A tomogram with a series of the captured images would allow the determination of their spatial distribution. In this study, bright-field (BF) images acquired with UHV-TEM at a high tilt angle prevented the construction of the tomogram. Conversely, the Z-contrast images acquired by the medium-voltage TEM produced a successful tomogram. The spatial resolution for both is discussed, illustrating that the image degradation was primarily caused by beam divergence of the Z-contrast image and the combination of DOF and chromatic aberration of the BF image from the UHV-TEM.
The microstructural analysis of the dehydrogenation products of the Ca(BH4)2–MgH2 composite was performed using transmission electron microscopy. It was found that nanocrystalline CaB6 crystallites formed as a dehydrogenation product throughout the areas where the signals of Ca and Mg were simultaneously detected, in addition to relatively coarse Mg crystallites. The uniform distribution of the nanocrystalline CaB6 crystallites appears to play a key role in the rehydrogenation of the dehydrogenation products, which implies that microstructure is a crucial factor determining the reversibility of reactive hydride composites.
Er3+-doped oxyfluoride transparent glass and glass-ceramics (GCs) containing SrF2 nanocrystals were prepared and their spectroscopic properties were investigated. The formation of SrF2 nanocrystals in GCs has been confirmed by x-ray diffraction (XRD) and transmission electron microscopy. The Judd-Ofelt (JO) parameters have been evaluated from absorption spectra of the Er3+-doped glass and GCs, which are used to predict radiative properties for some important luminescence levels of Er3+ ions in glass and GCs. The XRD and JO parameters suggest that the Er3+ ions are progressively incorporated into the SrF2 nanocrystals in the GCs compared with glass. The up-conversion luminescence intensity increases significantly in GCs with increase in time of thermal treatment. The lifetime of the 4S3/2 level of the Er3+ ions in GCs is found to be slightly higher than that in the glass due to the incorporation of Er3+ ions into the lower phonon energy of SrF2 nanocrystals in the GCs.
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.
A descriptive cross-sectional study.
Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2009.
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.
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).
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.
As one of the most important force production mechanisms of swimming and flying animals, the fluid dynamics of flapping has been intensively studied. However, these efforts have been mainly directed toward animals in forward motion or locomotive appendages undergoing linear translation. Here we seek to complement the existing knowledge of the flapping mechanism by studying angularly reciprocating flat plates without a free stream velocity, under a so-called ‘bollard pull’ condition. We visualize the flow field around the flat plate to find that two independent vortical structures are formed per half-cycle, resulting in the separation of two distinct vortex pairs at sharp edges rather than a single vortex loop which is typical of a starting–stopping vortex paradigm in flows with free streams. Based on our observations, we derive a scaling law to predict the thrust of the flapping plate; this is the first experimentally validated theoretical model for the thrust of angularly reciprocating plates without a prescribed background flow.
At the Seoul National University accelerator mass spectrometry (AMS) laboratory, we are planning to develop an automated sample preparation system for higher throughput of radiocarbon dating. This system will consist of several sections, including a combustion line, CO2 trap, graphitization system, and so on. We usually collect CO2 by cryogenic trapping. However, since handling liquid nitrogen is expected to be rather difficult, we are interested in replacing the cryogenic method with the molecular sieve method for the collection of CO2. In this study, we compare the performance of the cryogenic trapping method and molecular sieve method. Zeolite 13X is used as a molecular sieve, and as test samples we use the oxalic acid standard (NIST SRM 4990C), high-purity graphite powder, and archaeological charcoals. The pMC values and the radiocarbon ages (BP) obtained from samples prepared by the above 2 methods are very similar. We especially focused on the memory effect of the molecular sieve, meaning the CO2 contamination from a previous sample, which can cause errors in age determination. To reduce this effect, we flowed He gas through a zeolite container for several minutes at a high temperature before the CO2 was introduced. By the adding this step, we have obtained more reliable results.