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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.
Mycoplasma pneumoniae is a main pathogen causing community-acquired pneumonia in children and young adults. Since the emergence of macrolide-resistant M. pneumoniae in the early 2000s in Japan, it has been increasingly reported worldwide as a growing problem in treatment for children. With increasing macrolide-resistant M. pneumoniae and limited data regarding its characterization and molecular analysis, we investigated the dominant M. pneumoniae strains during the recent outbreak in South Korea, and evaluated if there was an association between a specific type and macrolide resistance. Between October 2014 and December 2016 in South Korea, 249 respiratory specimens obtained from patients with confirmed M. pneumoniae pneumonia were genotyped the P1 adhesin gene, and the mutations associated with resistance (A2063G and A2064G) were tested by sequencing the targeted domain V regions of the 23S ribosomal RNA gene. Results revealed that M. pneumoniae type 1 were predominant, which was strongly associated with macrolide-resistance during the whole study period. This is the first study assessing whether M. pneumoniae subtype is related to macrolide resistance during the outbreak of M. pneumoniae.
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.
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.
A total of forty weaned pigs ((Landrace×Yorkshire)×Duroc) were used to evaluate the effects of Lactobacillus acidophilus on inflammatory activity after lipopolysaccharide (LPS) challenge. Experimental treatments were as follows: (T1) control diet+saline challenge; (T2) control diet with 0·1 % L. acidophilus+saline challenge; (T3) control diet+LPS challenge; and (T4) control diet with 0·1 % L. acidophilus+LPS challenge. On d-14, piglets were challenged with saline (T1 and T2) or LPS (T3 and T4). Blood samples were obtained at 0, 2, 4, 6 and 12 h after being challenged and analysed for immune cell cytokine production and gene expression pattern. The L. acidophilus treatment increased the average daily weight gain (ADWG) and average daily feed intake (ADFI) compared with the control diet. With the control diet, the LPS challenge (T3) increased the number of immune cells and expression of TNF-α and IL-6 compared with the saline challenge (T1). Whereas with the saline challenge L. acidophilus treatment (T2) increased the number of leucocytes and CD4 compared with the control diet (T1), with the LPS challenge L. acidophilus treatment (T4) decreased the number of leucocytes, lymphocytes, CD4+ and CD8+ and expression of TNF-α and IL-6 compared with the control diet (T3). L. acidophilus treatment decreased the expression of TRL4 and NF-κB in peripheral blood mononuclear cells (PBMC) after LPS challenge, which leads to inhibition of TNF-α, IFN-γ, IL-6, IL-8 and IL1B1 and to induction of IL-4 and IL-10. We suggested that L. acidophilus improved ADWG and ADFI and protected against LPS-induced inflammatory responses by regulating TLR4 and NF-κB expression in porcine PBMC.
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
We report on the formation of highly flexible and transparent TiO2/Ag/ITO multilayer films deposited on polyethylene terephthalate substrates. The optical and electrical properties of the multilayer films were investigated as a function of oxide thickness. The transmission window gradually shifted toward lower energies with increasing oxide thickness. The TiO2 (40 nm)/Ag (18 nm)/ITO (40 nm) films gave the transmittance of 93.1% at 560 nm. The relationship between transmittance and oxide thickness was simulated using the scattering matrix method to understand high transmittance. As the oxide thickness increased from 20 to 50 nm, the carrier concentration gradually decreased from 1.08 × 1022 to 6.66 × 1021 cm−3, while the sheet resistance varied from 5.8 to 6.1 Ω/sq. Haacke's figure of merit reached a maximum at 40 nm and then decreased with increasing oxide thickness. The change in resistance for the 60 nm-thick ITO single film rapidly increased with increasing bending cycles, while that of the TiO2/Ag/ITO (40 nm/18 nm/40 nm) film remained virtually unchanged during the bending test.
The solid-state reaction of yttrium aluminum garnet (YAG, Y3Al5O12) during the heat treatment of Y2O3 and Al2O3 powder mixtures, differing in particle size and size ratio, was quantified using in situ high-temperature x-ray analysis and Rietveld refinement. Y2O3 particle size has the most profound effect on YAG formation. When the Y2O3 particle size was decreased from 5000 to 30 nm (on reaction with 270 nm Al2O3), the YAG formation rate increased from 20 to 48 vol% min−1 over the temperature range of 1350–1450 °C. In this case, the final YAG content increased from 75 to 91 vol%. A simple model that includes the reactant particle coordination number, and thus particle size ratio, shows that when the size ratio (dA/dY) is >1 diffusion through the alumina powder is rate controlling whereas when the ratio is <1, diffusion through the yttria, intermediate phases, and YAG is rate controlling.
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 work demonstrates design methods that can achieve remarkable enhancement in the stopband response of microstrip coupled-line filters. The frequencies of resonance and/or the transmission zeros of a coupled-line section can be controlled by its length. Therefore, by constructing a filter with coupled lines of incommensurate lengths such that these frequencies do not overlap, substantial improvement in the stopband response can be obtained. Besides its compact structure and simple design procedure, an unprecedented performance is demonstrated experimentally in which the transmission level is maintained below −20 dB up to as high as 11.9 f0 for a third-order filter, where f0 is the center frequency.
The electroluminescent characteristics of blue organic light-emitting diodes(BOLEDs) were fabricated with single emitting layer using host-dopant system and doped charge carrier transport layers. The structure of the high efficiency BOLED device was; NPB(600Å)/NPB:BCzVBi-7%(100Å)/ADN:BCzVBi-7%(300Å)/BAlq:BCzVBi-7%(100Å)/BAlq(200Å)/Liq(20Å)/Al(1200Å) to optimize probability of exciton generation by doping BCzVBi in emitting layer and hole/electron transport layers(HTL/ETL) as well. Luminance and luminous efficiency of BOLED doped BCzVBi in EML and HTL/ETL improved from 10090 cd/m2 at 9.5V and 6.44 cd/A at 4.0V to 13190 cd/m2 at 9.5V and 7.64 cd/A at 4.0V about 30% and 18%, respectively, with CIE coordinates of (0.14, 0.17) comparing to BOLED doped BCzVBi in EML only
In this study, we fabricated blue OLEDs with quantum well structure (QWS) using four different blue emissive materials such as DPVBi, ADN and DPASN, and BAlq as QWS material. Conventional QWS blue OLEDs used to be composed of emissive layer and charge blocking layer with lower HOMO-LUMO energy level, but we designed triple emitting layer for more significant hole-electron recombination in EML and a wider region of exciton generation as forming QWS spontaneously. The structure of triple emitting layered blue OLED is ITO / NPB(700 Å) / X(100 Å) / BAlq(100 Å) /X (100 Å) / Bphen(300 Å) / Liq(20 Å) / Al(1200 Å) (X= DPVBi, ADN, DPASN). HOMO-LUMO energy levels of DPVBi, ADN, DPASN and BAlq were 2.8-5.9, 2.6-5.6, 2.3-5.2 and 2.9-5.9 eV, respectively. The maximum luminous efficiency was 5.32 cd/A at 3.5 V in a blue OLED with DPASN / BAlq / DPASN QWS.
Here we report an epoch-making simple fabrication for wrinkle formation. The present wrinkle formation process is a solution for controlling the area, shape and direction of wrinkle area by forming wrinkles on the liquid state polydimethylsiloxane directly exposed to sputtered metal particles in the low vacuum plasma chamber in various vacuum states and deposition conditions. Also the process allows us to make extremely flexible metal thin film electrode with approved adhesion. These bring us possibilities of actual electrical and biological applications.
To apply the superconducting wire to power machines, it is necessary to conduct research on the characteristics of wire phase changes in connection with insulating layers. In this study, according to the presence or absence of insulating layers in the wire, and to the thickness of such layers, the wire's resistance increase trends and the characteristics of its recovery from quenching were examined by current-applied cycle at the temperatures of 90 K, 180 K and 250 K. Towards this end, YBCO thin-film wires that have the same critical temperatures and that have copper and stainless-steel stabilizing layers were prepared. One level and three and five levels of superior-performance polyimide pressure-sensitive adhesive tape was attached to the wires at a very low temperature. The eight prepared test samples were wound around the linear frames, then the wire's voltage and current created owing to the phase change characteristics were measured at each prescribed temperature, using the four-point probe method. Further, near the examination temperatures of 90 K, 180 K and 250 K the wire's resistance and recovery characteristics were examined by cycle.
The globular cluster system in M31 is an ideal laboratory for studying the formation and evolution of M31 as well as the globular clusters themselves. There have been numerous surveys and studies of the globular clusters in M31. However, only recently has the entire body of M31 been searched for globular clusters using wide-field CCD images by our group. A new era for the M31 globular cluster system has begun with the advent of wide-field CCD surveys of M31. We have discovered more than 100 new globular clusters in M31. Our catalog currently includes more than 500 globular clusters confirmed either based on spectra or HST images, many more than in the Milky Way. We present the structure, kinematics and chemical abundance of the M31 globular cluster system based on this large sample, and the implications for the formation and evolution of M31.
Semiconductors or metal nanoparticles (NPs) using their monolayer bindings with self-assembly chemicals are an attractive topic for device researchers. Electrical performance of such structures can be investigated for a particular application, such as memory device. Currently, Au NPs has been reported to show a substantial potential in the memory applications. In this study, Au NP and gluing layer were fabricated through a new method of monolayer formation of a chemical bonding or gluing.
In this study, a new NPs memory system was fabricated by using organic semiconductor, i.e., pentacene as the active layer, evaporated Au as electrode, SiO2 as the gate insulator layer on silicon wafer. In addition, Au NPs coated with binding chemicals were used as charge storage elements on an APTES (3-amino-propyltriethoxysilane) as a gluing layer. In order to investigate chemical binding of Au NP to the gate insulator layer, GPTMS (3-glycidoxy-propyltrimethoxysilane) were coated on the Au NPs. As a result of that, a layer of gold nanoparticles has been incorporated into a metal-pentacene-insulator-semiconductor (MPIS) structure. The MPIS device with the Au NP exhibited a hysteresis in its capacitance versus voltage analysis. Charge storage in the layer of nanoparticles is thought to be responsible for this effect.
A novel route to organic-inorganic composites was described based on biomineralization of poly(ethylene glycol) (PEG)-based hydrogels. The 3-dimensional hydrogels were synthesized by radical crosslinking polymerization of poly(ethylene glycol fumarate) (PEGF) in the presence of ethylene glycol methacrylate phosphate (EGMP) as an apatite-nuclating monomer, acrylamide (AAm) as a composition-modulating comonomer, and potassium persulfate (PPS) as a radical initiator. We used the urea-mediated solution precipitation technique for biomineralization of hydrogels. The apatite grown on the surface and interior of the hydrogel was similar to biological apatites in the composition and crystalline structure. Powder x-ray diffraction (XRD) showed that the calcium phosphate crystalline platelets on hydrogels are preferentially aligned along the crystallographic c-axis direction. Inductively-coupled plasma mass spectroscopy (ICP-MS) analysis showed that the Ca/P molar ratio of apatites grown on the hydrogel template was found to be 1.60, which is identical to that of natural bones. In vitro cell experiments showed that the cell adhesion/proliferation on the mineralized hydrogel was more pronounced than on the pure polymer hydrogel.