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This research investigated patients who underwent surgery for a dilated aorta associated with a connective tissue disease or inflammatory vasculitis in children and adolescents.
Materials and Methods:
The medical records of 11 patients who underwent aortic surgery for dilatation resulting from a connective tissue disease or inflammatory vasculitis between 2000 and 2017 were retrospectively reviewed.
The median age and body weight of the patients were 9.6 years (range 5.4 months–15.5 years) and 25.8 kg (range 6.8–81.5), respectively. The associated diseases were Marfan syndrome (n = 3), Loeys-Dietz syndrome (n = 3), Kawasaki disease (n = 1), Takayasu arteritis (n = 1), PHACE syndrome (n = 1), tuberous sclerosis (n = 1), and unknown (n = 1). The most common initially affected area was the ascending aorta. During the 66.4 ± 35.9 months of follow-up, two Marfan syndrome patients died, and four patients (one Marfan syndrome and three Loeys-Dietz syndrome) had repeated aortic operation. Except for one patient, the functional class was well maintained in all patients who were followed up.
Cases of surgical treatment for a dilated aorta associated with a connective tissue disease and inflammatory vasculitis are rare in children and adolescents at our institution. Most of the patients in this study showed a tolerable postoperative course. However, the aorta showed progressive dilation over time even after surgical treatment, especially in patients with Loeys-Dietz syndrome. In these patients, close and more frequent regular follow-up is required.
Adequate facepiece fit of N95 filtering facepiece respirators (FFRs) is crucial for optimal protection against airborne pathogens. The quantitative fit test (QNFT) pass rates of the 4 N95 FFR models commonly used in Korea were below 50%. Male sex was identified as a single independent predictive factor for QNFT pass.
It has not been well established whether dietary folate intake reduces the risk of diabetes development. We aimed to clarify the prospective association between dietary folate intake and type 2 diabetes (T2D) risk among 7333 Korean adults aged 40 years or older who were included in the Multi-Rural Communities Cohort. Dietary folate intake was estimated from all 106 food items listed on a FFQ, not including folate intake from supplements. Two different measurements of dietary folate intake were used: the baseline consumption and the average consumption from baseline until just before the end of follow-up. The association between folate intake and T2D risk was determined through a modified Poisson regression model with a robust error estimator controlling for potential confounders. For 29 745 person years, 319 cases of diabetes were ascertained. In multivariable analyses, dietary folate intake was inversely associated with risk of T2D for women, not for men. For women, the incidence rate ratio of diabetes in the third tertile compared with the first tertile was 0·57 (95 % CI 0·38–0·87, Pfor trend=0·0085) in the baseline consumption model and 0·64 (95 % CI 0·43–0·95, Pfor trend=0·0244) in the average consumption model. These inverse associations was found in both normal fasting blood glucose group and impaired fasting glucose group among women. Among non-users of multinutrients and vitamin supplements, the significant inverse association remained. Thus, higher dietary intake of folate is prospectively associated with lower risk of diabetes for women.
We demonstrate the tungsten disulfide (WS2) thin film catalysts prepared by the sulfurization of vacuum deposited WO3 thin films for efficient hydrogen production with over 90% Faradaic efficiency. The 23-nm-thick WS2 thin film catalyst heterojunction with p-type silicon photocathode could exhibit a photocurrent density of 8.3 mA/cm2 at 0 V versus a reversible hydrogen electrode (RHE), a low onset potential of 0.2 V versus RHE when photocurrent density reaches −1 mA/cm2 and long-term stability over 10 h. The enhanced catalytic activities of WS2/p-Si photocathodes compared with the bare p-Si photocathode originate from a number of edge sites in the synthesized polycrystalline thin films, which could act as hydrogen evolution catalyst.
This study examined the effects of a variety of metallurgical factors on the electrochemical corrosion behavior of superaustenitic stainless steel welds. First, the effects of the sigma (σ)-phase on the corrosion behavior were studied by means of a three-dimensional-atom probe. Cr and Mo depletion areas formed around the σ-phases which are precipitated in the interdendritic area were clearly observed. Second, the effects of oxide inclusion on the pitting corrosion of the steel welds were analyzed. The utilization of high resolution transmission electron microscope clearly demonstrated that the thickness and Cr content of the passive film formed on the steel surface decreased significantly with decreasing distance to the oxide inclusion, resulting in a deterioration of the corrosion resistance. Third, the effects of alloying elements, Cu and Al, were evaluated using an electrochemical polarization technique. This confirmed that Cu has a detrimental effect on the resistance to localized corrosion of the steel. The addition of Al up to 0.25 wt% had no significant effects on corrosion resistance in a chloride environment despite the presence of an Al-based oxide layer (Al2O3) on the outermost surface.
Cerebral white matter hyperintensities (WMH) are prevalent incident findings on brain MRI scans among elderly people and have been consistently implicated in cognitive dysfunction. However, differential roles of WMH by region in cognitive function are still unclear. The aim of this study was to ascertain the differential role of regional WMH in predicting progression from mild cognitive impairment (MCI) to different subtypes of dementia.
Participants were recruited from the Clinical Research Center for Dementia of South Korea (CREDOS) study. A total of 622 participants with MCI diagnoses at baseline and follow-up evaluations were included for the analysis. Initial MRI scans were rated for WMH on a visual rating scale developed for the CREDOS. Differential effects of regional WMH in predicting incident dementia were evaluated using the Cox proportional hazards model.
Of the 622 participants with MCI at baseline, 139 patients (22.3%) converted to all-cause dementia over a median of 14.3 (range 6.0–36.5) months. Severe periventricular WMH (PWMH) predicted incident all-cause dementia (Hazard ratio (HR) 2.22; 95% confidence interval (CI) 1.43–3.43) and Alzheimer's disease (AD) (HR 1.86; 95% CI 1.12–3.07). Subcortical vascular dementia (SVD) was predicted by both PWMH (HR 16.14; 95% CI 1.97–132.06) and DWMH (HR 8.77; 95% CI 1.77–43.49) in more severe form (≥ 10 mm).
WMH differentially predict dementia by region and severity. Our findings suggest that PWMH may play an independent role in the pathogenesis of dementia, especially in AD.
Many transgenic domestic animals have been developed to produce therapeutic proteins in the mammary gland, and this approach is one of the most important methods for agricultural and biomedical applications. However, expression and secretion of a protein varies because transgenes are integrated at random sites in the genome. In addition, distal enhancers are very important for transcriptional gene regulation and tissue-specific gene expression. Development of a vector system regulated accurately in the genome is needed to improve production of therapeutic proteins. The objective of this study was to develop a knock-in system for expression of human fibroblast growth factor 2 (FGF2) in the bovine β-casein gene locus. The F2A sequence was fused to the human FGF2 gene and inserted into exon 3 of the β-casein gene. We detected expression of human FGF2 mRNA in the HC11 mouse mammary epithelial cells by RT-PCR and human FGF2 protein in the culture media using western blot analysis when the knock-in vector was introduced. We transfected the knock-in vector into bovine ear fibroblasts and produced knock-in fibroblasts using the clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 system. Moreover, the CRISPR/Cas9 system was more efficient than conventional methods. In addition, we produced knock-in blastocysts by somatic cell nuclear transfer using the knock-in fibroblasts. Our knock-in fibroblasts may help to create cloned embryos for development of transgenic dairy cattle expressing human FGF2 protein in the mammary gland via the expression system of the bovine β-casein gene.
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
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.
The catalytic activity of Pt nanoparticles (NPs) significantly influences the electrochemical performance of direct methanol fuel cells. Information about the factors that influence the electrochemical activity of the catalyst themselves is scarce; hence, guidelines for the preparation of Pt NPs that yields the best performances are lacking. With consideration for this situation, we systematically investigated the relationship(s) between the characteristics of Pt NPs and their electrochemical performance. The general characteristics of Pt NPs, such as the average size, loading density, and dispersion status on the support, were varied in the presence of poly(acrylic acid)-wrapped multiwalled carbon nanotubes by controlling the preparation conditions, including the pH of the aqueous solution, the reaction temperature, and the reaction time. The enhanced catalytic activity is attributable to higher degree of dispersion, specific surface area, and electrochemically active surface area of Pt NPs. The optimized catalyst exhibits a ∼165% higher catalytic activity toward methanol oxidation than the commercial E-TEK.
Oxidative stress may be affected by lead exposure as well as antioxidants, yet little is known about the interaction between dietary antioxidants and blood lead levels (BLL) on oxidative stress level. We investigated the interaction between dietary antioxidants and BLL on oxidative stress level. As part of the Biomarker Monitoring for Environmental Health conducted in Seoul and Incheon, Korea, between April and December 2005, we analysed data from 683 adults (female = 47·4 %, mean age 51·4 (sd 8·4) years) who had complete measures on BLL, dietary intakes and oxidative stress marker (urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG)). Dietary intakes were assessed by a validated semi-quantitative FFQ, BLL was measured using atomic absorption spectrophotometry, and 8-OHdG by ELISA. Multivariate linear regression analyses were used to evaluate the influence of BLL on the association between dietary antioxidants and 8-OHdG. Geometric means of BLL and 8-OHdG concentrations were 4·1 (sd 1·5) μg/dl and 5·4 (sd 1·9) μg/g creatinine, respectively. Increases of vitamins C and E were significantly associated with the decrease of log10 8-OHdG in the adults from the lowest quartile of the BLL group ( ≤ 3·18 μg/dl, geometric mean = 2·36 μg/dl) than those of the highest quartile BLL group (>5·36 μg/dl, geometric mean = 6·78 μg/dl). Regarding antioxidant-related foods, vegetables excluding kimchi showed a higher inverse relationship with 8-OHdG in the lowest quartile BLL group than the highest group. These findings suggest a rationale for lowering the BLL and increasing the intake of dietary antioxidants in the urban population in Korea.
The EU has promoted energy efficiency in the built environment through policy and legislation such as the Energy Performance of Buildings Directive (EPBD) (EU, 2002) and also through funded research projects including several focused on the definition, validation and dissemination of the EU Passive House standard for new and renovated buildings. The UK and its devolved parliaments have developed their own policy and legislation aimed at reducing energy use and carbon emissions associated with the built environment largely in synergy with the EU. In this chapter we review a selection of the EU and UK legislative approaches.
Building on this review, the types of new and renovated buildings that these policy initiatives will tend to promote are illustrated; and an analysis of some of these probable future buildings is undertaken to illustrate the likely changes in energy demands that will result. Some key factors which have large future uncertainties are identified and potential consequences of these uncertainties projected. Finally we discuss the potential increased use of heat pumps for heating and cooling and the increased deployment of photovoltaic and CHP (combined heat and power) generation systems and discuss some of the potential challenges for the generation, grid and distribution network.
In order to decarbonize the energy-supply system, policies have been introduced to stimulate an increase in the amount of energy we use from clean and renewable energy systems. With the progressive increase in the quantities of clean and renewable energy-supply systems being commissioned, there comes a point where due to the intermittency and unpredictability of renewables it is difficult to maintain a demand–supply balance. In such circumstances, the traditional control theories of energy supply being demand following cannot be enacted. In order to maintain the integrity of the demand–supply match, the onus of control needs to shift from the supply side to the demand side. Ideally, we would like to have flexibility and infinite control over each load so that control can be enacted which enables the energy demand to become supply following. The control being enacted on each load type would be such that the functionality or comfort levels each individual load is satisfying would not be compromised. Thus, this level of discrete control would result in the building occupant/user being unaware of control measures being enacted. In practice, however, this may not be feasible. Therefore the purpose of this chapter is to explore how we may achieve increased levels of control over individual loads, the impact this will have on introducing flexibility into the demand side, and how this could be implemented at a practical level.
Drivers for DSM and control within buildings
A number of drivers exist to influence and accelerate the penetration of demand-side management (DSM) within the built environment, specifically within the domestic sector. These drivers include evolving energy policy, improved energy efficiency through the use of more efficient appliances, the increased uptake and technological advancements in the microgeneration system, and the development and application of information and communication technologies to control and optimize the energy supply–demand match, while being sympathetic to the building environmental conditions being attained.
The silicidation reactions and thermal stability of Co silicide formed from Co-Ta/Si systems have been investigated. In case of Co-Ta alloy process, the formation of low resistive CoSi2phase is delayed to about 660°C, as compared to conventional Co/Si system. Moreover, the presence of Ta in Co-Ta alloy films reduces the silicidation reaction rate, resulting in the strong preferential orientation in CoSi2 films. Upon high temperature post annealing in the furnace, the sheet resistance of Co-silicide formed from Co/Si systems increases significantly, while that of Co-Ta/Si systems maintains low. This is due to the formation of TaSi2 at the grain boundaries and surface of Co-silicide films, which prevents the grain boundary migration thereby slowing the agglomeration. Therefore, from our research, increased thermal stability of Co-silicide films was successfully obtained from Co-Ta alloy process.
The influence of operating parameters in producing light-emitting porous silicon materials was investigated in ethanolic solutions of hydrofluoric acid. Photoluminescence spectra depended on applied potential, the intensity and wavelength of illumination, and electrolyte concentration. When the applied potential and the illumination wavelength increased, the photoluminescence shifted to longer wavelength. Change in HF concentration resulted in different intensity in photoluminescence.
In this study, the quality of thin film diode (TFD) as a switching device for active-matrix liquid-crystal-displays (AM-LCDs) was enhanced by low temperature annealing conditions with high reliability and good electrical properties. Device was composed with Ta as bottom electrode, anodic Ta2O5 as insulator layer and top electrode. Two types of material such as Ti and Cr were evaluated as a top electrode of the TFD device to optimize the symmetry of current-voltage characteristic curve, respectively. The annealing was done at low temperature conditions below 350°C. The low temperature annealing improved the TFD device with nearly perfect symmetry under high electric field.
We report a new excimer laser annealing method by employing selectively floating a-Si active layer structure in order to increase the grain size of poly-Si film. The floating a-Si region blocks the heat conduction into the underlying substrate due to high thermal-insulating property of an air so that the lateral temperature gradient is successfully induced by the proposed simple air-gap structure. Our experimental results show that large grains were grown in the lateral direction from the edge to the center of the floating active region. The large grains exceeding 4 m were successfully obtained with only one laser irradiation.
We report new lateral grain growth mechanism by XeCl excimer laser annealing on a-Si film with pre-patterned Al layer. 2000Å-thick Al pattern on 800Å-thick PECVD a-Si film successfully reflects the incident laser beam and results in temperature gradient during the recrystallization process. The TEM images show that grain growth near the boundary between the liquid and the solid region exhibits a different mechanism compared with the conventional ELA. About 1.5 m-long lateral grain has been successfully obtained by single laser irradiation
A poly-Si TFT with single grain boundary in the channel has been fabricated by the proposed excimer laser annealing. An excellent device characteristics such as mobility more than 250cm2/Vsec, high On/Off current ratio of 6.3×106 and low threshold voltage less than 1 V has been obtained. The experimental results show that the mobility, threshold voltage and sub-threshold slope of proposed TFTs are superior to those of the conventional TFTs.
A high-quality silicon dioxide (SiO2) suitable for a gate oxide on plastic substrates is successfully deposited by e-gun evaporation at room temperature. The e-gun evaporated oxide film is free from troublesome hydrogen atoms and high-energy ion damage, which ensures good electrical characteristics. N2O/N2 plasma post-treatment was effective to reduce the flat band voltage and leakage current of the evaporated oxides due to the passivation of high-energy nitrogen and oxygen radicals. In the SiO2 film treated by N2O/N2 plasma for 1 minute, the flat band voltage has been reduced from −2.5V to about −0.5V and the leakage current has been decreased by more than one order. Our experimental results show that very low temperature SiO2 film suitable for a gate insulator of TFTs on the plastic substrates has been successfully obtained by the e-gun evaporation and N2O/N2 plasma post-treatment.