To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Since the significance of metacognition as the theoretical basis of a psychological intervention for schizophrenia first emerged, there have been ongoing attempts to restore or strengthen patients’ metacognitive abilities.
A Korean version of the metacognitive training (MCT) program was developed, and its effects on theory of mind, positive and negative symptoms, and interpersonal relationships were examined in stable outpatients with schizophrenia.
A pre-test–post-test design with a control group was used. The participants were 59 outpatients (30 in experimental group, 29 in control group) registered at five mental health facilities in a city in South Korea. The developed MCT program was applied for a total of 18 sessions, 60 min per session, over a period of 14 weeks. The hinting task, false belief task, Scale for the Assessment of Positive and Negative Symptoms, and Relationship Change Scale were used to verify the effects of this program. Data were analysed by the chi-square test, t-test, and Mann–Whitney U-test using the SPSS/PASW 18.0 statistics program.
The general characteristics, intelligence, and outcome variables of the two groups were homogeneous. After the intervention, the experimental group showed significant improvements in theory of mind, positive and negative symptoms and interpersonal relationships compared with the control group.
These results suggest that the MCT program can be a complementary psychotherapy that contributes to symptom relief and interpersonal functioning in patients with schizophrenia, and is effective in the Korean culture, beyond the Western context.
Refugees commonly experience difficulties with emotional processing, such as alexithymia, due to stressful or traumatic experiences. However, the functional connectivity of the amygdala, which is central to emotional processing, has yet to be assessed in refugees. Thus, the present study investigated the resting-state functional connectivity of the amygdala and its association with emotional processing in North Korean (NK) refugees.
This study included 45 NK refugees and 40 native South Koreans (SK). All participants were administered the Toronto Alexithymia Scale (TAS), Beck Depression Inventory (BDI), and Clinician-administered PTSD Scale (CAPS), and differences between NK refugees and native SK in terms of resting-state functional connectivity of the amygdala were assessed. Additionally, the association between the strength of amygdala connectivity and the TAS score was examined.
Resting-state connectivity values from the left amygdala to the bilateral dorsolateral prefrontal cortex (dlPFC) and dorsal anterior cingulate cortex (dACC) were higher in NK refugees than in native SK. Additionally, the strength of connectivity between the left amygdala and right dlPFC was positively associated with TAS score after controlling for the number of traumatic experiences and BDI and CAPS scores.
The present study found that NK refugees exhibited heightened frontal–amygdala connectivity, and that this connectivity was correlated with alexithymia. The present results suggest that increased frontal–amygdala connectivity in refugees may represent frontal down-regulation of the amygdala, which in turn may produce alexithymia.
Scholars often assume that reference groups are industry-wide, homogeneous, and stable. We examine this assumption and suggest hypotheses based on managers’ motivations such as self-enhancement and self-improvement, social identity, and affiliation-based impression management. We test hypotheses on failure-induced changes in reference groups and their direction in terms of upward and downward comparisons. An empirical examination of changes in reference groups for firms listed on the Dow Jones Industrial Average Index between 1993 and 2008 shows that performance below social aspirations induces changes in reference groups and toward upward comparisons. The results indicate that managers can choose to change the reference group – a cognition-centered response – as an alternative to such action-centered responses as organizational search and risk-taking in response to poor performance from social aspirations and that upward comparisons may be the result of social performance shortfalls to give a better impression and to improve firm performance.
Given its diverse disease courses and symptom presentations, multiple phenotype dimensions with different biological underpinnings are expected with bipolar disorders (BPs). In this study, we aimed to identify lifetime BP psychopathology dimensions. We also explored the differing associations with bipolar I (BP-I) and bipolar II (BP-II) disorders.
We included a total of 307 subjects with BPs in the analysis. For the factor analysis, we chose six variables related to clinical courses, 29 indicators covering lifetime symptoms of mood episodes, and 6 specific comorbid conditions. To determine the relationships among the identified phenotypic dimensions and their effects on differentiating BP subtypes, we applied structural equation modeling.
We selected a six-factor solution through scree plot, Velicer's minimum average partial test, and face validity evaluations; the six factors were cyclicity, depression, atypical vegetative symptoms, elation, psychotic/irritable mania, and comorbidity. In the path analysis, five factors excluding atypical vegetative symptoms were associated with one another. Cyclicity, depression, and comorbidity had positive associations, and they correlated negatively with psychotic/irritable mania; elation showed positive correlations with cyclicity and psychotic/irritable mania. Depression, cyclicity, and comorbidity were stronger in BP-II than in BP-I, and they contributed significantly to the distinction between the two disorders.
We identified six phenotype dimensions; in addition to symptom features of manic and depressive episodes, various comorbidities and high cyclicity constructed separate dimensions. Except for atypical vegetative symptoms, all factors showed a complex interdependency and played roles in discriminating BP-II from BP-I.
Vertically aligned BaTiO3 nanowire (NW) arrays on a Ti substrate were adopted for use in piezoelectric energy harvesting device that scavenges electricity from mechanical energy. BaTiO3 NWs were simultaneously grown at the top and bottom surfaces of a Ti substrate by two-step hydrothermal process. To characterized the piezoelectric output performance of the individual NW, we transferred a BaTiO3 single NW that was selected from well-aligned NW arrays onto a flexible substrate and measured the electric signals during the bending/unbending motions. For fabricating a piezoelectric energy harvester (PEH), both NW arrays were sandwiched between two transparent indium tin oxide (ITO)-coated polyethylene terephthalate (PET) plastic films and then packaged with polydimethylsiloxane (PDMS) elastomer. A lead-free BaTiO3 NW array-based PEH produced an output voltage of about 90 V and a maximum current of 1.2 μA under periodically bending motions.
Our objective was to evaluate long-term altered appearance, distress, and body image in posttreatment breast cancer patients and compare them with those of patients undergoing active treatment and with general population controls.
We conducted a cross-sectional survey between May and December of 2010. We studied 138 breast cancer patients undergoing active treatment and 128 posttreatment patients from 23 Korean hospitals and 315 age- and area-matched subjects drawn from the general population. Breast, hair, and skin changes, distress, and body image were assessed using visual analogue scales and the EORTC BR–23. Average levels of distress were compared across groups, and linear regression was utilized to identify the factors associated with body image.
Compared to active-treatment patients, posttreatment patients reported similar breast changes (6.6 vs. 6.2), hair loss (7.7 vs. 6.7), and skin changes (5.8 vs. 5.4), and both groups had significantly more severe changes than those of the general population controls (p < 0.01). For a similar level of altered appearance, however, breast cancer patients experienced significantly higher levels of distress than the general population. In multivariate analysis, patients with high altered appearance distress reported significantly poorer body image (–20.7, CI95% = –28.3 to –13.1) than patients with low distress.
Significance of results:
Posttreatment breast cancer patients experienced similar levels of altered appearance, distress, and body-image disturbance relative to patients undergoing active treatment but significantly higher distress and poorer body image than members of the general population. Healthcare professionals should acknowledge the possible long-term effects of altered appearance among breast cancer survivors and help them to manage the associated distress and psychological consequences.
The aim of this study is to develop predictive models to predict organ at risk (OAR) complication level, classification of OAR dose-volume and combination of this function with our in-house developed treatment decision support system.
Materials and methods
We analysed the support vector machine and decision tree algorithm for predicting OAR complication level and toxicity in order to integrate this function into our in-house radiation treatment planning decision support system. A total of 12 TomoTherapyTM treatment plans for prostate cancer were established, and a hundred modelled plans were generated to analyse the toxicity prediction for bladder and rectum.
The toxicity prediction algorithm analysis showed 91·0% accuracy in the training process. A scatter plot for bladder and rectum was obtained by 100 modelled plans and classification result derived. OAR complication level was analysed and risk factor for 25% bladder and 50% rectum was detected by decision tree. Therefore, it was shown that complication prediction of patients using big data-based clinical information is possible.
We verified the accuracy of the tested algorithm using prostate cancer cases. Side effects can be minimised by applying this predictive modelling algorithm with the planning decision support system for patient-specific radiotherapy planning.
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.
Personality may predispose family caregivers to experience caregiving differently in similar situations and influence the outcomes of caregiving. A limited body of research has examined the role of some personality traits for health-related quality of life (HRQoL) among family caregivers of persons with dementia (PWD) in relation to burden and depression.
Data from a large clinic-based national study in South Korea, the Caregivers of Alzheimer's Disease Research (CARE), were analyzed (N = 476). Path analysis was performed to explore the association between family caregivers’ personality traits and HRQoL. With depression and burden as mediating factors, direct and indirect associations between five personality traits and HRQoL of family caregivers were examined.
Results demonstrated the mediating role of caregiver burden and depression in linking two personality traits (neuroticism and extraversion) and HRQoL. Neuroticism and extraversion directly and indirectly influenced the mental HRQoL of caregivers. Neuroticism and extraversion only indirectly influenced their physical HRQoL. Neuroticism increased the caregiver's depression, whereas extraversion decreased it. Neuroticism only was mediated by burden to influence depression and mental and physical HRQoL.
Personality traits can influence caregiving outcomes and be viewed as an individual resource of the caregiver. A family caregiver's personality characteristics need to be assessed for tailoring support programs to get the optimal benefits from caregiver interventions.
The development of embryonic stem cells (ESCs) from large animal species has become an important model for therapeutic cloning using ESCs derived by somatic cell nuclear transfer (SCNT). However, poor embryo quality and blastocyst formation have been major limitations for derivation of cloned ESCs (ntESCs). In this study, we have tried to overcome these problems by treating these cells with histone deacetylase inhibitors (HDACi) and aggregating porcine embryos. First, cloned embryos were treated with Scriptaid to confirm the effect of HDACi on cloned embryo quality. The Scriptaid-treated blastocysts showed significantly higher total cell numbers (29.50 ± 2.10) than non-treated blastocysts (22.29 ± 1.50, P < 0.05). Next, cloned embryo quality and blastocyst formation were analyzed in aggregates. Three zona-free, reconstructed, four-cell-stage SCNT embryos were injected into the empty zona of hatched parthenogenetic (PA) blastocysts. Blastocyst formation and total cell number of cloned blastocysts increased significantly for all aggregates (76.4% and 83.18 ± 8.33) compared with non-aggregates (25.5% and 27.11 ± 1.67, P < 0.05). Finally, aggregated blastocysts were cultured on a feeder layer to examine the efficiency of porcine ES-like cell derivation. Aggregated blastocysts showed a higher primary colony formation rate than non-aggregated cloned blastocysts (17.6 ± 12.3% vs. 2.2 ± 1.35%, respectively, P < 0.05). In addition, derived ES-like cells showed typical characters of ESCs. In conclusion, the aggregation of porcine SCNT embryos at the four-cell stage could be a useful technique for improving the development rate and quality of porcine-cloned blastocysts and the derivation efficiency of porcine ntESCs.
To date, many studies surveying the bacterial communities in lichen thalli from diverse geographical areas have shown that Alphaproteobacteria is the predominant bacterial class in most lichens. In this study, bacterial communities in several Antarctic lichens with different growth form and substrates were analysed. The bacterial community composition in fruticose and foliose lichens, Cladonia, Umbilicaria and Usnea, and crustose lichens, Buelia granulosa, Amandinea coniops and Ochrolechia parella, from King George Island was analysed by pyrosequencing of bacterial 16S rRNA genes. Results showed that Proteobacteria, Acidobacteria, Actinobacteria and Bacteroidetes were predominant phyla. The predominant bacterial class in most of the samples was Alphaproteobacteria. Acetobacteriaceae of the order Rhodospiralles in Alphaproteobacteria was the most abundant bacterial family in Antarctic lichens. The LAR1 lineage of the order Rhizobiales, a putative N-fixer which has been frequently observed in lichens from temperate areas, was detected only from a few samples at low frequency. It is expected that other bacterial taxa are working as N-fixers in Antarctic lichens. From the PCoA analysis of the Fast UniFrac distance matrix, it was proposed that the microbial community structures in Antarctic lichens were affected by host species, growth form and substrates.
To examine the hypothesis that the association between vitamin D deficiency and depressive symptoms is dependent upon total cholesterol level in a representative national sample of the South Korean population.
This was a population-based cross-sectional study.
The Fifth Korean National Health and Nutrition Examination Survey (KNHANES V, 2010–2012).
We included 7198 adults aged 20–88 years.
The incidence of depressive symptoms in individuals with vitamin D deficiency (serum 25-hydroxyvitamin D<20 ng/ml) was 1·54-fold (95 % CI 1·20, 1·98) greater than in individuals without vitamin D deficiency (serum 25-hydroxyvitamin D ≥20 ng/ml). The relationship was stronger in individuals with normal-to-borderline serum total cholesterol (serum total cholesterol<240 mg/dl; OR=1·60; 95 % CI 1·23, 2·08) and non-significant in individuals with high serum total cholesterol (OR=0·97; 95 % CI 0·52, 1·81) after adjustment for confounding variables (age, sex, BMI, alcohol consumption, smoking status, regular exercise, income level, education level, marital status, changes in body weight, perceived body shape, season of examination date and cholesterol profiles).
The association between vitamin D deficiency and depressive symptoms was weakened by high serum total cholesterol status. These findings suggest that both vitamin D and total cholesterol are important targets for the prevention and treatment of depression.
Instabilities in the flow past a rounded square cylinder have been numerically studied in order to clarify the effects of rounding the sharp edges of a square cylinder on the primary and secondary instabilities associated with the flow. Rounding the edges was done by inscribing a quarter circle of radius
in each edge of a square cylinder of height
. Nine cases of rounding were considered, ranging from a square cylinder (
) to a circular cylinder (
) with an increment of 0.0625. Each cross-section was numerically implemented in a Cartesian grid system by using an immersed boundary method. The key parameters are the Reynolds number (Re) and the edge-radius ratio (
). For low Re, the flow is steady and symmetric with respect to the centreline. Over the first critical Reynolds number (
), the flow undergoes a Hopf bifurcation to a time-periodic flow, termed the primary instability. As Re further increases, the onset of the secondary instability of three-dimensional (3D) nature is detected beyond the second critical Reynolds number (
). Rounding the sharp edges of a square cylinder significantly affects the flow topology, leading to noticeable changes in both instabilities. By employing the Stuart–Landau equation, we investigated the criticality of the primary instability depending upon
. The onset of the 3D secondary instability was detected by using Floquet stability analysis. The temporal and spatial characteristics of the dominant modes (A, B, QP) were described. The neutral stability curves of each mode were computed depending upon
Background: Dysphagia is a common symptom and an important prognostic factor in Parkinson’s disease (PD). Although cognitive and motor dysfunctions may contribute to dysphagia in patients with PD, any specific association between such problems and swallowing functions is unclear. Here, we examined the potential relationship between cognitive/motor components and swallowing functions in PD. We evaluated the contributions of cognition and motor function to the components of swallowing via video fluoroscopic swallowing (VFS) experiments. Methods: We prospectively enrolled 56 patients without dementia having PD. Parkinson’s disease severity was assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS). All participants received neuropsychological tests covering general mental status, visuospatial function, attention, language, learning and memory, and frontal executive function. The well-validated “modified barium swallow impairment profile” scoring system was applied during VFS studies to quantify swallowing impairments. Finally, correlations between neuropsychological or motor functions and impairment in swallowing components were calculated. Results: The most significant correlations were found between the frontal/executive or learning/memory domains and the oral phase of swallowing, though a minor component of the pharyngeal phase correlated with frontal function as well. Bradykinesia and the UPDRS total score were associated with both the pharyngeal and oral phases. Conclusions: Our findings suggest that cognitive dysfunctions are associated with the oral phase of swallowing in patients with early stage PD while the severity of motor symptoms may be associated with overall swallowing function.
A total of 27 accessions from ten Vicia species were investigated for flavonoid contents, total polyphenol contents, and DPPH (2,2-diphenyl-1-picrylhydrazyl) and ABTS [2,2′-azinobis(3-ethylbenzothiazoline 6-sulfonic acid)] free radical-scavenging activities. The results revealed that NAC17 (V. monantha) and NAC14 (V. hyrcanica) had the highest total flavonoid content (1.42 ± 0.09 mg/g) and total polyphenol content [124.2 ± 0.5 μg/gallic acid equivalents (GAE) mg], respectively. Among four flavonoids, naringenin was detected at high concentrations in Vicia species. The DPPH and ABTS assays showed values in the range of 57.2 (IC50) (NAC13, V. faba) to 6530.0 (IC50) (NAC24, V. sativa subsp. nigra) and 19.1 μg/Trolox mg (NAC7, V. cracca) to 253.4 μg/Trolox mg (NAC13, V. faba), respectively. Among ten Vicia species, V. monantha and V. hyrcanica had the highest flavonoid content (1.31 ± 0.09 mg/g) and total polyphenol content (116.5 ± 2.0 μg/GAE mg), respectively. The highest antioxidant activity was detected in V. faba. These results will expand the flavonoid database and provide valuable information on Vicia species for the development of functional foods or feed-additive resources.
During the past decade, carbapenemase-producing Enterobacteriaceae (CPE) has emerged and spread across the world.1 The major carbapenemase enzymes currently being reported are KPC, NDM-1, VIM, IMP, and OXA.2 Because carbapenemase can be effectively transmitted via mobile genetic elements, and current therapeutic options for CPE infections are extremely limited, CPE may be one of the most serious contemporary threats to public health. However, very little is known about the characteristics of CPE carriage during hospitalization. The aims of this study were to investigate the clearance rate of CPE carriage and determine the number of consecutive negative cultures required to confirm CPE clearance. We also examined CPE transmission among hospitalized patients.
Infect. Control Hosp. Epidemiol. 2015;36(11):1361–1362
A quantitative analysis of In concentration in InGaN/GaN multiquantum wells in light-emitting diodes was carried out using high-resolution transmission electron microscopy (HRTEM) and high-angle annual dark-field scanning TEM (HAADF-STEM). The In composition in InGaN was evaluated by the precise measurement of c-lattice parameters in the HRTEM micrographs, which increase with increasing In composition. The reliability of the results was confirmed by high-resolution x-ray diffraction measurements and Rutherford backscattering spectrometry. Quantitative In compositions can, therefore, be determined using HRTEM. We tried to determine the quantitative In compositions in InGaN by analyzing the intensity profiles of the HAADF-STEM images. However, several problems were encountered, such as differences in the thickness of the region observed, carbon contamination, and ion beam damage during specimen preparation. Therefore, relative differences in composition were observed in the HAADF-STEM images.
Decreased hemoglobin levels increase the risk of developing dementia among the elderly. However, the underlying mechanisms that link decreased hemoglobin levels to incident dementia still remain unclear, possibly due to the fact that few studies have reported on the relationship between low hemoglobin levels and neuroimaging markers. We, therefore, investigated the relationships between decreased hemoglobin levels, cerebral small-vessel disease (CSVD), and cortical atrophy in cognitively healthy women and men.
Cognitively normal women (n = 1,022) and men (n = 1,018) who underwent medical check-ups and magnetic resonance imaging (MRI) were enrolled at a health promotion center. We measured hemoglobin levels, white matter hyperintensities (WMH) scales, lacunes, and microbleeds. Cortical thickness was automatically measured using surface based methods. Multivariate regression analyses were performed after controlling for possible confounders.
Decreased hemoglobin levels were not associated with the presence of WMH, lacunes, or microbleeds in women and men. Among women, decreased hemoglobin levels were associated with decreased cortical thickness in the frontal (Estimates, 95% confidence interval, −0.007, (−0.013, −0.001)), temporal (−0.010, (−0.018, −0.002)), parietal (−0.009, (−0.015, −0.003)), and occipital regions (−0.011, (−0.019, −0.003)). Among men, however, no associations were observed between hemoglobin levels and cortical thickness.
Our findings suggested that decreased hemoglobin levels affected cortical atrophy, but not increased CSVD, among women, although the association is modest. Given the paucity of modifiable risk factors for age-related cognitive decline, our results have important public health implications.