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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.
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.
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.
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.
Epidemiological studies have reported that higher education (HE) is associated with a reduced risk of incident Alzheimer's disease (AD). However, after the clinical onset of AD, patients with HE levels show more rapid cognitive decline than patients with lower education (LE) levels. Although education level and cognition have been linked, there have been few longitudinal studies investigating the relationship between education level and cortical decline in patients with AD. The aim of this study was to compare the topography of cortical atrophy longitudinally between AD patients with HE (HE-AD) and AD patients with LE (LE-AD).
We prospectively recruited 36 patients with early-stage AD and 14 normal controls. The patients were classified into two groups according to educational level, 23 HE-AD (>9 years) and 13 LE-AD (≤9 years).
As AD progressed over the 5-year longitudinal follow-ups, the HE-AD showed a significant group-by-time interaction in the right dorsolateral frontal and precuneus, and the left parahippocampal regions compared to the LE-AD.
Our study reveals that the preliminary longitudinal effect of HE accelerates cortical atrophy in AD patients over time, which underlines the importance of education level for predicting prognosis.
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.
This study aimed to investigate the influences of age, education, and gender on the two total scores (TS-I and TS-II) of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological assessment battery (CERAD-NP) and to provide normative information based on an analysis for a large number of elderly persons with a wide range of educational levels.
In the study, 1,987 community-dwelling healthy volunteers (620 males and 1,367 females; 50–90 years of age; and zero to 25 years of education) were included. People with serious neurological, medical, and psychiatric disorders (including dementia) were excluded. All participants underwent the CERAD-NP assessment. TS-I was generated by summing raw scores from the CERAD-NP subtests, excluding Mini-Mental State Examination and Constructional Praxis (CP) recall subtests. TS-II was calculated by adding CP recall score to TS-I.
Both TS-I and TS-II were significantly influenced by demographic variables. Education accounted for the greatest proportion of score variance. Interaction effect between age and gender was found. Based on the results obtained, normative data of the CERAD-NP total scores were stratified by age (six overlapping tables), education (four strata), and gender.
The normative information will be very useful for better interpretation of the CERAD-NP total scores in various clinical and research settings and for comparing individuals’ performance of the battery across countries.
Genetic variation in wild soybean (Glycine soja Sieb. and Zucc.) is a valuable resource for crop improvement efforts. Soybean is believed to have originated from China, Korea, and Japan, but little is known about the diversity or evolution of Korean wild soybean. Therefore, in this study, we evaluated the genetic diversity and population structure of 733 G. soja accessions collected in Korea using 21 simple sequence repeat (SSR) markers. The SSR loci produced 539 alleles (25.7 per locus) with a mean genetic diversity of 0.882 in these accessions. Rare alleles, those with a frequency of less than 5%, represented 75% of the total number. This collection was divided into two populations based on the principal coordinate analysis. Accessions from population 1 were distributed throughout the country, whereas most of the accessions from population 2 were distributed on the western side of the Taebaek and Sobaek mountains. The Korean G. soja collection evaluated in this study should provide useful background information for allele mining approach and breeding programmes to introgress alleles into the cultivated soybean (G. max (L). Merr.) from wild soybean.
This study quantitatively investigated the immediate effects of a photooxidative collagen cross-linking treatment with photosensitizer riboflavin (RF) and 370 nm UVA light in in vitro human corneoscleral collagen fibrils using histology, thickness, scanning electron microscopy, and atomic force microscopy analyses. Twenty 8 × 2 mm corneoscleral strips were dissected sagittally from donor tissue using a scalpel. Four parameters were investigated, including the density, thickness, adhesion force, and stiffness of corneoscleral tissues before and after the collagen cross-linking treatment. The RFUVA-catalyzed collagen cross-linking treatment led to an increase in the density of both corneal (8%) and scleral (23%) stromal collagens. However, there was no difference in corneoscleral thickness. Furthermore, RFUVA-catalyzed collagen cross-linking treatment led to an increased biomechanical response of corneosclera: 25 and 8% increases in corneoscleral stiffness, and 24 and 22% increases in corneoscleral adhesion force. The collagen cross-linking treatment through RF-sensitized photoreaction may cause structural and biomechanical changes in the collagen fibril network of the cornea and the sclera. This is due to narrowing of the interfibrillar spacing and the stromal edema.
This study investigated the inflammatory effect of intraoperative mitomycin C (MMC) on adhesion reformation in human rectus muscles. Ten consecutive patients who underwent medial rectus resection had their postoperative rectus muscles divided into two groups: control group (n = 10) and MMC group (n = 10). In the MMC group, the muscle was soaked for 2 min with MMC, prepared as a 0.2 mg/mL (0.02%) solution. The 0.02% MMC reactions were examined using histological analysis with hematoxylin-eosin (inflammatory response) and Masson's trichrome (collagen fibrils), immunoreactivities of cyclooxygenase-II (inflammatory response), and collagen type I and III, scanning electron microscopy analysis to quantify the diameter and D-periodicity of collagen fibrils, and atomic force microscopy analysis to quantify the diameter, D-periodicity, and adhesion force of collagen fibrils. The rectus muscles treated with 0.02% MMC showed a significantly increased inflammatory response (p < 0.05), increased collagen density (p < 0.0001), increased fibril diameter (p < 0.001 or p < 0.05), and decreased fibril adhesion force (p < 0.005) compared to the rectus muscles in the control group. MMC simultaneously caused an inflammatory response as well as nanostructural and biomechanical property changes in the collagen fibril network.
The effects of cinnamaldehyde (CINN) on in vitro parameters of immunity and in vivo protection against avian coccidiosis were evaluated. In vitro stimulation of chicken spleen lymphocytes with CINN (25–400 ng/ml) induced greater cell proliferation compared with the medium control (P < 0·001). CINN activated cultured macrophages to produce higher levels of NO at 1·2–5·0 μg/ml (P < 0·001), inhibited the growth of chicken tumour cells at 0·6–2·5 μg/ml (P < 0·001) and reduced the viability of Eimeriatenella parasites at 10 and 100 μg/ml (P < 0·05 and P < 0·001, respectively), compared with media controls. In chickens fed a diet supplemented with CINN at 14·4 mg/kg, the levels of IL-1β, IL-6, IL-15 and interferon-γ transcripts in intestinal lymphocytes were 2- to 47-fold higher (P < 0·001) compared with chickens given a non-supplemented diet. To determine the effect of CINN diets on avian coccidiosis, chickens were fed diets supplemented with CINN at 14·4 mg/kg (E. maxima or E. tenella) or 125 mg/kg (E. acervulina) from hatch for 24 d, and orally infected with 2·0 × 104 sporulated oocysts at age 14 d. CINN-fed chickens showed 16·5 and 41·6 % increased body-weight gains between 0–9 d post-infection (DPI) with E. acervulina or E. maxima, reduced E. acervulina oocyst shedding between 5–9 DPI and increased E. tenella-stimulated parasite antibody responses at 9 DPI compared with controls.
Silicon nanocrystals were in situ grown in a silicon nitride film by plasma enhanced chemical vapor deposition. The size and structure of silicon nanocrystals were confirmed by high-resolution transmission electron microscopy. Depending on the size, the photoluminescence of silicon nanocrystals can be tuned from the near infrared (1.38 eV) to the ultraviolet (3.02 eV). The fitted photoluminescence peak energy as E(eV) = 1.16 + 11.8/d2 is an evidence for the quantum confinement effect in silicon nanocrystals. The results demonstrate that the band gap of silicon nanocrystals embedded in silicon nitride matrix was more effectively controlled for a wide range of luminescent wavelengths.
We report a new Ni/Pt/Au (20/30/80 nm) metallization scheme to achieve a low ohmic contacts to p-type GaN with a carrier concentration of 9.4 × 1016 cm-3. A Mg-doped GaN layer (0.5 μm) was grown on (0001) sapphire substrate by metalorganic chemical vapor deposition (MOCVD). All metal thin films were deposited on the p-GaN layer in an electron-beam evaporation system. Samples were annealed by a rapid thermal annealing (RTA) process at a range of temperatures from 300 °C to 850 °C under a flowing Ar atmosphere. A circulartransmission line model (c-TLM) was employed to calculate the specific contact resistance, and current-voltage (I-V) data were measured with HP4155A. The Ni/Pt/Au contacts without the annealing process showed nearly rectifying characteristics. The ohmic contacts were formed on the samples annealed at 500 °C for 30 sec and the I-V data showed a linear behavior. The specific contact resistance was 2.1 × 10-2 Ωcm2. However with increasing the annealing temperature above 600 °C, ohmic contacts were again degraded. Auger electron spectroscopy (AES) depth profiles were used to investigate the interfacial reactions between the trilayer and GaN. AES results suggested that Pt plays a significant role in forming ohmic contact as an acceptor at the interface. Atomic force microscope (AFM) also showed that the samples with good ohmic contact have very smooth surface.
The quarternary CIGS nanoparticles for absorber layer of solar cells have been synthesized with various mole ratios by colloidal route. The CIGS nanoparticles were prepared by reacting CuI, InI3, GaI3 in pyridine with Na2Se in methanol at 0°C under inert atmosphere. For Cu0.9In0.8Ga0.3Se2 and Cu0.9In0.7Ga0.4Se2 stoichiometric ratios, tube-type nanofibers were obtained with the widths in the range of 20–50 nm and lengths of 0.1–3 μm from reaction at 0°C for 20 min. For Cu1.1In0.68Ga0.23Se1.91, and Cu0.9In0.68Ga0.23Se1.91 ratios, spherical nanoparticles were obtained from the same reaction condition. As compared to particles from Cu0.9In0.68Ga0.23Se1.91 ratio, more uniform and smaller nanoparticles with diameter in the range of 5–20 nm were obtained from the Cu1.1In0.68Ga0.23Se1.91 stoichiometric ratio. The morphology change of the CIGS particles seems to be closely related to the ratio of Cu/(In, Ga).
Zinc oxide (ZnO) thin films have emerged as one of the most promising oxide materials owing to their optical and electrical properties, together with their high chemical and mechanical stability. Chemical solution deposition (CSD) is attractive technique for obtaining ZnO thin films and has the advantages of easy control of the film composition and easy fabrication of a larger-area thin film at low cost. In this work, epitaxial ZnO thin films on SiC substrate were prepared by using a CSD method with a zinc naphthenate precursor. Precursor films were pyrolyzed at 500°C for 10 min in air and finally annealed at 600°C, 700°C, 800°C and 900°C for 30 min in air. Crystallinity and in-plane alignment of the films were investigated by X-ray diffraction theta-2 theta scan and pole-figure analysis. Scanning electron microscope, scanning probe microscope, and He-Cd laser (325 nm) are used to detect the surface morphology and photoluminescence of the films. The effects of annealing temperature on crystallinity and epitaxy of the films will be fully discussed on the basis of the results of X-ray diffraction analysis.
CIGS nanoparticles for the CIGS absorber layer have been synthesized by low temperature colloidal routes. The CIGS absorber layers for solar cells have been prepared by spray deposition of CIGS nanoparticle precursors (∼20 nm) in glove box under inert atmosphere. An automatic air atomizing nozzle spray system with computer controlled X-Y step motor system was used to spray. The nanoparticle precursor CIGS film was deposited onto molybdenum-coated soda-lime glass substrates (2.5 cm × 5.0 cm) heated to 160°C. The film thickness in the range of 2 μm ± 0.3 μm was attained by spraying of 3 mM colloidal over an area of 12.5 cm2. The coalescence between particles was observed in the CIGS absorber layer under post-treatment of over 550 °C. This is related to the reactive sintering among the nanoparticles to reduce surface energy of the particles. The CuxSe thin film, formed on Mo film by evaporation, improved adhesion between CIGS and Mo layers and enhanced the coalescence of the particles in the CIGS layer. These are closely related to the fluxing of Cu2Se phase which has relatively low melting temperature. The CdS buffer layer was deposited on the CIGS/Mo/soda-lime glass substrate by chemical bath deposition. The CIGS nanoparticles-based absorber layers were characterized by using energy dispersive spectroscopy (EDS), x-ray diffraction (XRD) and high-resolution scanning electron microscopy (HRSEM).
A systematic study on the effect of sputtering deposition parameters on material properties of Al doped ZnO (ZnO:Al) films prepared by an in-line rf magnetron sputtering and on surface morphology of the films after wet etching process was carried out. For application to silicon thin film solar cells as a front electrode, the as-deposited films were surface-textured by a dilute HCl solution to improve the light scattering properties such as haze and angle resolved distribution of scattered light on the film surfaces. The microstructure of as-deposited films is affected significantly by the working pressure and film compactness decreases with increasing working pressure from 1.5 mTorr to 10 mTorr. High quality ZnO:Al films with electrical resistivity of 4.25 × 10-4 Ω cm and optical transmittance of 80% in a visible range are obtained at low working pressure of 1.5 mTorr and substrate temperature of 100℃. Crater-like surface morphologies are observed on the textured ZnO:Al films after wet etching. The size and shape of craters are closely dependent on the microstructure and film compactness of as-deposited films. Haze values of the textured ZnO:Al films are improved in a whole wavelength of 300 – 1100 nm compared to commercial SnO2:F films (Asahi U type) and incident light on the textured films is scattered effectively with 30° angle.
The effects of thermal stress on antioxidant defences in tissues of the Antarctic clam Laternula elliptica were evaluated and the activities of some antioxidant enzymes, and levels of total glutathione (GSH) and protein carbonyl (PC) in digestive gland and gill over 0–4 days under extreme thermal stress (10°C) were measured. Superoxide dismutase activity was slightly higher after one day of thermal stress, although catalase activity was not altered significantly in either digestive gland or gill tissues. Thermal stress was associated with a significant increase in the activity of GSH-related antioxidant enzymes. Glutathione peroxidase and glutathione reductase activities increased up to 1.8- and 2.0-fold, respectively, after two days of thermal stress. Glutathione S-transferase activity drastically increased, to over 3.4- and 4.2-fold in digestive gland and gill, respectively, and remained high on day four. GSH levels also increased in both tissues and remained high on day four. PC content, a marker of protein oxidation, increased after two days of thermal stress. There is evidence that GSH-related antioxidant defence plays a significant role in relation to potential toxicity from reactive oxygen species during thermal stress.
Prevailing dietary patterns and their association with nutritional outcomes are poorly understood, particularly for children in Korea. Our purposes were to identify major dietary patterns and to examine their associations with overweight among young children in Korea. For 1441 preschool children, usual diet was assessed by a FFQ, from which thirty-three food groups were created and entered into a factor analysis. We identified three dietary patterns by relative intake frequency of (1) vegetables, seaweeds, beans, fruits, milk and dairy products (Korean healthy pattern); (2) beef, pork, poultry, fish and fast foods (animal foods pattern); and (3) ice cream, soda, chocolate, cookies and candies (sweets pattern). The Korean healthy pattern was associated with better health status. As compared with the lowest quintile, the multivariate-adjusted OR of the highest quintile for health status inferior or similar to their peers was 0·59 (95 % CI 0·42, 0·84). Likelihood of being overweight was higher among those in the highest quintile (OR 1·77 (95 % CI 1·06, 2·94)) v. the lowest quintile regarding the animal foods pattern. These findings suggest that major dietary patterns are predictors of overweight and health status in Korean preschool children.