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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 verify the validity of a semiautomated surgical site infection (SSI) surveillance system using electronic screening algorithms in 38 categories of surgery.
A cohort study for validation of semiautomated SSI surveillance system using screening algorithms.
A 1,989-bed tertiary-care referral center in Seoul, Republic of Korea.
A dataset of 40,516 surgical procedures in 38 categories stored in the conventional SSI surveillance registry at the Samsung Medical Center between January 2013 and December 2014 was used as the reference standard. In the semiautomated surveillance system, electronic screening algorithms flagged cases meeting at least 1 of 3 criteria: antibiotic prescription, microbial culture, and infectious disease consultation. Flagged cases were audited by infection preventionists. Analyses of sensitivity, specificity, and positive predictive value (PPV) were conducted for the semiautomated surveillance system, and its effect on reducing the workload for chart review was evaluated.
A total of 575 SSI events (1·42%) were identified by conventional SSI surveillance. The sensitivity of the semiautomated SSI surveillance was 96·7%, and the PPV of the screening algorithms alone was 4·1%. Semiautomated SSI surveillance reduced the chart review workload of the infection preventionists from 1,283 to 482 person hours per year (a 62·4% decrease).
Compared to conventional surveillance, semiautomated surveillance using electronic screening algorithms followed by chart review of selected cases can provide high-validity surveillance results and can significantly reduce the workload of infection preventionists.
Cronobacter sakazakii is a life-threatening foodborne pathogen found in powdered infant formula and dairy products. Kefir is a dairy probiotic product and its antimicrobial activity against C. sakazakii was reported in our previous study. To identify key microorganisms that mediate growth suppression, we tested the antimicrobial activity of culture supernatants derived from lactic acid bacteria found in kefir. Lactobacillus kefiri DH5, L. kefiranofaciens DH101, and Bifidobacterium longum 720 (a commercial probiotic strain that served as a positive control) all significantly inhibited the growth of C. sakazakii ATCC 29544, delaying the initiation of exponential growth from 3 to 9 h in the nutrient broth. Among them, L. kefiri DH5 exerted the strongest antimicrobial effects against C. sakazakii, showing bactericidal effect at the addition of 300 µl of supernatant in 1 ml of nutrient broth. Interestingly, the supernatant of L. kefiri DH5 has higher pH and lower titrable acidity than that of L. kefiranofaciens DH101, suggesting metabolites produced by heterofermentation of L. kefiri acted more effectively to antagonise the growth of C. sakazakii. In addition, the supernatant of L. kefiri DH5 induced the leakage of cytoplasmic materials including nucleic acid and proteins, suggesting L. kefiri DH5 disrupted the cellular membrane integrity of C. sakazakii. Considering that pH neutralisation reduced the L. kefiri-dependent growth suppression, it is inferred that this activity is mainly due to organic acids produced during the fermentation process.
In this study, we design a differential CMOS power amplifier using a 180-nm SOI RFCMOS process for 802.11n (64-QAM, 20 MHz bandwidth, 9.6 dB peak to average power ratio (PAPR)) applications. To minimize the chip area and mismatch in differential signals, we propose a layout method with an inter-stage matching network using a split inductor. By virtue of the symmetrical layout of the proposed split inductor, the mismatch in the differential signals is minimized, while the interconnection lines between the driver and power stages are shortened to minimize the overall chip area and the loss induced by the resistive parasitic components. The designed power amplifier is measured using a wireless local area network (WLAN) 802.11n signal to verify the feasibility of the proposed layout technique. The power amplifier achieved 20.34 dBm output power, while the measured EVM for the 802.11n applications is satisfied. From the measured results, we successfully prove the feasibility of the proposed power amplifier.
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.
Psychological health is an important issue after disasters. This study aimed to investigate the prevalence of psychological symptoms among 993 residents of Taean District in South Korea after the Hebei Spirit oil spill and to examine determinants of vulnerability in residents’ psychological symptoms.
Symptoms of post-traumatic stress (PTS), depression, suicidal ideation, and anxiety were assessed by questionnaires, and the responses were analyzed by using the survey analysis considering the sampling frame.
Among the study subjects, the symptom prevalences of PTS, depression, suicidal ideation, and anxiety were 19.5%, 22.0%, 2.3%, and 4.2%, respectively, and symptoms were higher in people who were female, were older, were less educated, and had lower family income. People with fishery or related occupations compared to those with unrelated livelihoods and people residing in the vicinity of the oil band in the contaminated coastline showed additively increased symptom risks of PTS. Risk of suicidal ideation was predominantly increased in people with fishery or related occupations compared with those with unrelated livelihoods.
Social supports, including compensation for income loss and community mental health programs, and longer follow-up studies are needed for residents in the communities affected by the Hebei Spirit oil spill. (Disaster Med Public Health Preparedness. 2016;10:51-58)
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.
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.
The effects of polymer substrates on the interfacial structure and the thermal stability of Ga-doped ZnO (GZO) thin films were investigated. The GZO thin films were deposited on polyethylene terephthalate (PET) and polyethylene naphthalate (PEN) substrates by rf-magnetron sputtering at room temperature, and thermal stability tests of the GZO thin films on the polymer substrates were performed at 150°C up to 8 h in air. Electrical and structural characterizations of the GZO thin films on the PET and the PEN substrates were carried out, and the origins of the stable interfacial structure and the improved thermal stability of the GZO thin film on the PEN substrate were discussed.
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.
Using immunostaining methodology, we traced the axonal projection of FMRFamide (Phe-Met-Arg-Phe-NH2)-like immunoreactive (LI) medial neurosecretory cells (MNCs) and lateral neurosecretory cells (LNCs) from the brain into the ventral nerve cord (VNC) and retrocerebral complex in Bombyx mori (L.) (Lepidoptera: Bombycidae). Of the seven pairs of FMRFamide-LI MNCs, one pair extended its axons from the brain pars intercerebralis into the VNC ipsilateral connective where they appeared to terminate. The axons of the remaining MNCs ran through decussation in the brain median region and contralateral nervi corporis cardiaci (NCC) I out of the brain, and eventually innervated the contralateral corpus cardiacum (CC). Axons from the single pair of FMRFamide-LI LNCs projected into the ipsilateral NCC II fused with NCC I without decussation in the brain, and finally terminated in the CC. These results suggest that transport of the FMRFamide-like neuropeptide from may be related to the modulation of functions such as gut contraction in MNCs terminating in the VNC, and regulation of production and/or secretion of specific hormones such as juvenile hormone in MNCs and LNCs terminating in the CC.
We investigated the pressure dependence of the inductive coupled plasma (ICP) oxidation on the electrical characteristics of the thin oxide films. Activation energies and electron temperatures with different pressures were estimated. To demonstrate the pressure effect on the plasma oxide quality, simple N type metal-oxide-semiconductor (NMOS) transistors were fabricated and investigated in a few electrical properties. At higher pressure than 200mTorr, plasma oxide has a slightly higher on-current and a lower interfacial trap density. The on-current gain seems to be related to the field mobility increase and the lower defective interface to the electron temperature during oxidation.
The liquid lens based on MEMS technology can be an appropriate solution to improve the imaging capability of a capsule endoscope because it can be realized small enough and also consume negligible power. In this paper, a cylinder-type liquid lens was designed to minimize the dead area and then fabricated with MEMS technology combining the silicon thin-film process and the wafer bonding process where the multiple dielectric layer of Teflon, silicon nitride and thermal oxide was formed on the cylinder wall. The focal length of the lens module including the fabricated liquid lens was changed reproducibly as a function of the applied voltage. With the change of 30V in the applied bias, the focal length of the constructed lens module could be tuned in the range of about 42cm. The fabricated liquid lens was also proven to be small enough to be adopted in the capsule endoscope, which means the liquid lens can be utilized for the imaging capability improvement of the capsule endoscope.
A monodisperse spherical Y2O3:Eu3+ phosphor was prepared by a homogeneous precipitation method. The mean size of the phosphor particles (MSPP) was successfully controlled by changing the volume ratio of normal alcohol (RA) (propanol) in the solvents mixed between deionized water and normal propanol. When the RA was increased from 0 to 0.7, the MSPP decreased while maintaining a high yield of >95%. Although the prepared phosphor samples were fired at the same temperature, the thermal energy was delivered more efficiently into the inner side of the phosphor particles with the decrease of the MSPP. Therefore, the crystallinity and also the photoluminescence (PL) intensity of the phosphor increased with the decrease in the MSPP. In addition, because the numbers of Eu3+ ions located near the particle surfaces increased with the decrease of particle size, the ratio of PL intensity caused by the 5D0–7F2 transition to that caused by 5D0–7F1 transition increased from 10.8 to 12.7 with the decrease in MSPP.
Bump process using gold bump led to many cleaning problems like polymer residues, metal and polyimide consumption after stripping process. First of all, stripping process of bump photoresist is one of the difficult technologies since thickness of PR pattern of bump is thicker than that of general metal line at least 100 times. We investigated the improvement of LDI BUMP stripping Process at 25 with new chemical. We found that the wettability may be improved when the additive was added to the chemical and it improves the stripping ability. It was found that new chemical was superior to commercial chemical in terms of chemical stability, removal efficiency of polymer residue and decrease in metal and polyimide consumption. Also, we could obtain removal mechanism of photoresist pattern by measured Raman equipment and enhancement of yield in mass production line of semiconductor.
The adhesion force of pad and alumina were experimentally and theoretically investigated in slurry solutions of different pHs. The isoelectric point (IEP) of pad particles was measured to be around pH 3. The wafer surfaces showed negative zeta potentials in the investigated pH ranges with exception of FSG and Ta. Cu and Ta showed higher interaction forces than dielectric materials. The lowest adhesion force was measured between pad particle and wafer surfaces in a slurry solution of pH 11. The magnitude of adhesion force of pad particles was lower than alumina particles.
We present accurate BV light curves and continuum energy curves of the EROS eclipsing binaries in the Large Magellanic Cloud to find accurate binary parameters as well as their distances. The observations have been carried out using the 2.1 meter telescope in CASLEO Argentina during Feb. 1-10, 2003. We have concentrated CCD direct observations upon EROS field 1 and 2 to improve the accuracy of light curves of eclipsing binaries in the fields. The spectroscopic observations have been also carried out using the simple dispersion method to get continuum energy curves between wavelengths of 4000-8000 Å for several EROS eclipsing binaries. At first, we determined a combined temperature of both components of each binary system using the continuum. Then, the combined temperature was resolved using the first estimation of the light curve solution. Finally, we determined the photometric solutions of several binaries in the Large Magellanic Cloud.