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Depressive symptoms are common in bereaved caregivers; however, there have been few prospective studies using a structured interview. This study investigated the prevalence and preloss predictors of major depressive disorder (MDD) in bereaved caregivers of patients in a palliative care unit.
This prospective cohort study collected caregiver sociodemographic and psychological data before the death of a palliative care unit patient, including MDD, care-burden, coping style, and hopeful attitude. Postloss MDD was assessed 6 and 13 months after death, and a multivariate logistic regression analysis was conducted to identify its predictors.
Of 305 caregivers contacted, 92 participated in this study. The prevalence of preloss MDD was 21.8%; the prevalences of postloss MDD were 34.8% and 24.7% at 6 and 13 months, respectively. Preloss MDD predicted postloss MDD at 6 months (odds ratio [OR] = 5.38, 95% confidence interval [CI95%] = 1.29, 22.43); preloss nonhopeful attitude and unemployment status of caregivers predicted postloss MDD at 13 months (OR = 8.77, CI95% = 1.87, 41.13 and OR = 7.10, CI95% = 1.28, 39.36, respectively).
Significance of results
Approximately 35% of caregivers suffered from MDD at 6 months postloss, but the prevalence of MDD decreased to about 25% at 13 months. Preloss MDD significantly predicted postloss MDD at 6 months, whereas hopeful attitude and unemployment at baseline were significantly associated with postloss MDD at 13 months.
To secure the reliability of flexible electronics, the effect of multicomponent stress on the device properties during complex mechanical deformation needs to be thoroughly understood. The electrical resistances of metal interconnects are investigated by in situ monitoring at different twisting angles and with different pattern positions. As the twisting angle increased, the electrical resistance increased earlier. Furthermore, in the line pattern located far from the central axis, severe electrical degradation and fatigue damage formation were observed. Multicomponent stress evolution during twisting was analyzed by the finite-element simulation method. For easy practical application for estimating the representative twisting strain, an analytic solution of twisting deformation was formulated and compared with the simulation. Using the equivalent strain, the fatigue lifetime was fitted, and the exponents were obtained for lifetime expectation. This systematic study provides the guidelines for highly reliable flexible devices and the tools for determining the expected fatigue lifetime.
We trace Sn nanoparticles (NPs) produced from SnO2 nanotubes (NTs) during lithiation initialized by high energy e-beam irradiation. The growth dynamics of Sn NPs is visualized in liquid electrolytes by graphene liquid cell transmission electron microscopy. The observation reveals that Sn NPs grow on the surface of SnO2 NTs via coalescence and the final shape of agglomerated NPs is governed by surface energy of the Sn NPs and the interfacial energy between Sn NPs and SnO2 NTs. Our result will likely benefit more rational material design of the ideal interface for facile ion insertion.
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 determine the influence of caregiver personality and other factors on the burden of family caregivers of terminally ill cancer patients.
We investigated a wide range of factors related to the patient–family caregiver dyad in a palliative care setting using a cross-sectional design. Caregiver burden was assessed using the seven-item short version of the Zarit Burden Interview (ZBI–7). Caregiver personality was assessed using the 10-item short version of the Big Five Inventory (BFI–10), which measures the following five personality dimensions: extroversion, agreeableness, conscientiousness, neuroticism, and openness. Patient- and caregiver-related sociodemographic and psychological factors were included in the analysis because of their potential association with caregiver burden. Clinical patient data were obtained from medical charts or by using other measures. Multivariate linear regression analysis was performed to identify the independent factors associated with caregiver burden.
We analyzed 227 patient–family caregiver dyads. The multivariate analysis revealed that caregiver extroversion was protective against caregiver burden, whereas depressive symptoms in caregivers were related to increased burden. Neuroticism was positively correlated with caregiver burden, but this relationship was nonsignificant following adjustment for depressive symptoms. Patient-related factors were not significantly associated with caregiver burden.
Significance of Results:
Evaluating caregiver personality traits could facilitate identification of individuals at greater risk of high burden. Furthermore, depression screening and treatment programs for caregivers in palliative care settings are required to decrease caregiver burden.
Cancer is a leading cause of death, and the dietary pattern in Korea is changing rapidly from a traditional Korean diet to a Westernised diet. In the present study, we investigated the effects of dietary factors on cancer risk with a prospective cohort study. Among 26 815 individuals who participated in cancer screening examinations from September 2004 to December 2008, 8024 subjects who completed a self-administered questionnaire concerning demographic and lifestyle factors, and a 3 d food record were selected. As of September 2013, 387 cancer cases were identified from the National Cancer Registry System, and the remaining individuals were included in the control group. The hazard ratio (HR) of cancer for the subjects older than or equal to 50 years of age was higher (HR 1·80, 95 % CI 1·41, 2·31; P< 0·0001) than that for the other subjects. Red meat consumption, Na intake and obesity (BMI ≥ 25 kg/m2) were positively associated with overall cancer incidence in men (HR 1·41, 95 % CI 1·02, 1·94; P= 0·0382), gastric cancer (HR 2·34, 95 % CI 1·06, 5·19; P= 0·0365) and thyroid cancer (HR 1·56, 95 % CI 1·05, 2·31; P= 0·0270), respectively. Participants who had at least three dietary risk factors among the high intakes of red meat and Na, low intakes of vegetables and fruits, and obesity suggested by the World Cancer Research Fund/American Institute for Cancer Research at baseline tended to have a higher risk of cancer than the others (HR 1·26, 95 % CI 0·99, 1·60; P= 0·0653). In summary, high intakes of red meat and Na were significant risk factors of cancer among Koreans.
The diatoms are an ecologically important group of algae that have been extensively studied by ecologists and taxonomists. However, the large-scale patterns of diatom distribution and the factors underlying this distribution are largely unknown. The aims of this study were to identify the large-scale spatial patterns of benthic diatom assemblages in Korean streams and rivers, and to assess the importance of numerous environmental factors on diatom distribution. We classified 720 study sites based on diatom flora. Benthic diatoms, water chemistry, altitude, and riparian land cover and use were characterized by multivariate analyses, Monte Carlo permutation tests, and indicator species analysis. In total, we identified 531 diatom taxa. Diatom assemblages were mostly dominated by species of the genera Achnanthes, Navicula, Nitzschia, Cocconeis, Fragilaria (Synedra included), Cymbella, Gomphonema, and Melosira. Cluster analysis partitioned all 720 sites into eight groups based on diatom species composition. Canonical correspondence analysis indicated that altitude, land cover and use, current velocity, electrical conductivity, and nutrient levels explained a significant amount of the variation in the composition of assemblages of benthic diatoms. At the national scale, a downstream ecological gradient was apparent, from fast-flowing, mostly oligotrophic highland streams to slow-flowing, mostly eutrophic lowland rivers. Our data suggest that spatial factors explain some of the variation in diatom distribution. The present investigation of the spatial patterns of benthic diatoms, the ecological determinants of diatom occurrence, and the identification of diatom indicator species contributes to development of a program for assessing the biological integrity of lotic ecosystems in Korea.
Background: Extrapyramidal signs (EPSs), which are important characteristics of Parkinson's disease (PD), occur frequently in Alzheimer's disease (AD). Although AD and PD share common clinical features such as EPSs, these diseases vary with respect to vascular risk factors. The presence of vascular risk factors increases the risk of AD; however, these factors have been known to be inversely associated with PD. We aimed to assess the effect of vascular risk factors and white matter lesions (WMLs) on EPSs in AD.
Methods: We recruited 1,187 AD patients and 333 controls with neither cognitive impairment nor EPSs. All participants underwent detailed clinical evaluations which included assessments of vascular risk factors, cognitive function, and EPSs, as well as WMLs on brain MRIs. EPS subtypes were classified into tremor-dominant, postural instability gait difficulty, or indeterminate; WMLs subtypes were classified into periventricular WML (pvWML) or deep WML (dWML).
Results: EPSs were present in 17.9% of subjects with AD and were significantly associated with vascular risk factors such as age, male gender, diabetes mellitus, and WMLs. Additionally, a multivariate logistic regression analysis showed that EPSs in AD were associated with pvWML (odds ratio (OR), 1.61–2.52), not with dWML. With respect to EPS subtypes, the majority (78.4%) of EPSs in AD were postural instability gait difficulty, which was also associated with WMLs (OR 1.84–2.41), pvWML (OR 2.09–3.14), and dWML (OR 1.83–3.42).
Conclusions: EPSs in AD are associated with selected vascular risk factors as well as WMLs.
We aimed to investigate the factors associated with a positive intake of folic acid (FA) during the periconceptional period among Korean women.
In a cross-sectional study of demographic, obstetric and socio-economic data, history of periconceptional intake of FA and awareness of the benefits of FA supplementation in pregnancy were obtained and analysed using the χ2 test, followed by multiple logistic regression analysis.
The Maternity School, Cheil General Hospital and Women’s Healthcare Center, Seoul, South Korea, between October 2005 and March 2006.
In total 1313 pregnant women participating in a two-day training course available every month.
After excluding subjects with incomplete or inconsistent data, there were 1277 women included in the analysis. Participants were aged 29·4 (sd 2·9) years and had a mean gestational age of 27·9 (sd 7·1) weeks. Only 131 (10·3 %) women took FA during the periconceptional period. According to multiple logistic regression analyses, the adjusted OR for FA supplementation was 1·79 (95 % CI 1·10, 2·91) in women who had previous spontaneous abortions, 4·10 (95 % CI 2·43, 6·78) in women who planned their pregnancy and 6·63 (95 % CI 2·08, 21·12) in those who were aware of the protective effects of FA.
Periconceptional intake of FA was more likely among Korean women with a history of previous spontaneous abortion, who planned their pregnancy or who were aware of the protective effects of FA during pregnancy. However, the proportion of women who took FA in the periconceptional period was low.
A modified embedded-atom method (MEAM) interatomic potential for the Cu–Zr system has been developed based on the previously developed MEAM potentials for pure Cu and Zr. The potential describes fundamental physical properties and alloy behavior of the Cu–Zr binary system reasonably well. The applicability of the potential to atomistic investigations of mechanical and deformation behavior for the Cu–Zr binary and Cu–Zr-based multicomponent amorphous alloys is also demonstrated by showing that fully relaxed and realistic amorphous structures can be generated by molecular dynamics simulations.
Cu alloy has been suggested to enhance reliabilites in future technology. To evaluate the effects of alloying elements on electrical and mechanical reliabilities, Mg and Ru were chosen as alloying elements. Because alloying elements to Cu should not increase resistivity over comparable value to pure Cu, the resistivity of pure Cu, Cu-0.7at%Mg alloy and Cu-2.2at%Ru alloy was compared. Time dependent dielectric breakdown (TDDB) under bias-temperature stress (BTS) tests were accomplished to evaluate the effect of alloying elements on dielectric reliability. The standard four point bending experiments were conducted to measure critical interfacial adhesion energy of conducting metal to SiO2. The relationship of the effect of alloying elements on reliabilities to distribution of alloying elements was analyzed using Auger Electron Spectroscopy (AES). Our results show alloying Mg to Cu can enhance reliability by forming self-passivating layer on its surface and interface while Ru does not.
The line width dependence of stress in damascene Cu was examined experimentally as well as with a numerical simulation. The measured hydrostatic stress was found to increase with increasing line width. The larger stress in an interconnect with large dimension is attributed to the larger grain size, which induce higher growth stress in addition to thermomechanical stress. A stress model based on microstructure was constructed and the contribution of the growth and thermal stress of the damascene lines were quantified using finite element analysis. It was found that the stress of the via is lower than that of wide lines when both the growth stress and thermal stress were considered. This stress gradient between via and line, which is the driving force of vacancy diffusion, is larger when the low-k with lower stiffness and higher thermal expansion is used for dielectric layer. For this reason, the Cu/low-k can be more vulnerable to stress-induced voiding.
Various low-k materials are being pursued as dielectric materials for future interconnects. However, poor thermo-mechanical properties of low-k materials cause tremendous reliability concerns, thus the proper materials for integration with Cu are not suggested yet. In this study, the line width and spacing dependence of damascene Cu lines embedded by TEOS and low-k materials (CORAL) was analyzed using x-ray diffraction. Generally, the hydrostatic stress of Cu/TEOS was greater than that of Cu/CORAL, while the opposite for von-Mises stress. Using a three-dimensional finite analysis (FEA), the effect of low-k materials on the stress and its distribution in via-line structures of dual damascene Cu interconnects was studied. In the case of Cu/TEOS, the hydrostatic stress was concentrated at the via and on the top of the lines, where it was suspected that the void would nucleate. On the other hand, in the via-line structures integrated with organic low-k materials, large von-Mises stress was maintained in the via. Therefore, the deformation of via, rather than voiding, may be the main failure mode in the interconnects with low-k materials.
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