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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.
To evaluate the appropriateness of the screening strategy for healthcare personnel (HCP) during a hospital-associated Middle East Respiratory Syndrome (MERS) outbreak, we performed a serologic investigation in 189 rRT-PCR–negative HCP exposed and assigned to MERS patients. Although 20%–25% of HCP experienced MERS-like symptoms, none of them showed seroconversion by plaque reduction neutralization test (PRNT).
Background: Patients diagnosed with Parkinson’s disease (PD) on clinics who subsequently turn out to have normal dopamine transporter images have been referred to as scans without evidence of dopaminergic deficits (SWEDDs) patients. Cardiovascular autonomic dysfunction has frequently been reported in PD. In this study, we determined the similarities and differences in cardiac autonomic dysfunction between SWEDDs and PD patients. This study investigated whether 24-hour ambulatory blood pressure monitoring (24-hour ABPM) can help identify possible cases with SWEDDs. Methods: We enrolled 28 SWEDDs patients, 46 patients with PD, and 30 healthy controls. To evaluate cardiac autonomic function, 24-hour ABPM was performed on all subjects. Cardiac metaiodobenzylguanidine (MIBG) scintigraphy was performed on the SWEDDs and PD subjects. Results: The percentage nocturnal decline in blood pressure differed significantly among SWEDDs patients, PD patients, and controls (p<0.05). In addition to the abnormal nocturnal BP, regulation (nondipping and reverse dipping) was significantly higher in SWEDDs and PD subjects than in the control subjects (p<0.05). There was no significant correlation between the % nocturnal blood pressure reduction and parameters of cardiac MIBG uptake ratio. However, orthostatic hypotension was significant correlated with the nocturnal blood pressure dip (%), nocturnal blood pressure patterns, and the cardiac MIBG uptake ratio (early and late) in combined SWEDDs and PD subjects. Conclusions: Pathologic nocturnal blood pressure regulation and nocturnal hypertension, known characteristics of PD, are also present in SWEDDs. Moreover, cardiac sympathetic denervation should not be attributed to cardiac autonomic dysfunction in SWEDDs patients. As with PD patients, the SWEDDs patients studied here tended to have cardiac autonomic dysfunction.
Feasibility of multiwavelength Raman spectroscopy was studied as a potential
in-line monitoring technique for grain size distribution in channel poly-Si used
in three dimensional stacked NAND (3D NAND) Flash memory devices. Various
channel poly-Si materials in 3D-NAND Flash memory devices, converted from
chemical vapor deposition (CVD) grown a-Si, were characterized using
non-contact, multiwavelength Raman spectroscopy and high resolution
cross-sectional transmission electron microscopy (HRXTEM). The Raman
characterization results were compared with HRXTEM images. The correlation
between the grain size distribution characterized by multiwavelength Raman
spectroscopy and “on current” (ION) of 3D NAND
Flash memory devices was investigated. Good correlation between these techniques
was seen. Multiwavelength Raman spectroscopy is very promising as a
non-destructive in-line monitoring technique for grain size distribution in
channel poly-Si used in 3D NAND Flash memory devices.
The junction resistance control of conducting networks is a crucial factor for high performance of the network-structured conducting film. Here, we show that silver nanowire (AgNW) networks can be stabilized by using single-walled carbon nanotubes (SWCNTs) which were functionalized with 2-ureido-4[1H]pyrimidinone (UHP) moieties. UHP-modified SWCNTs allowed us to fabricate AgNW suspension containing SWCNTs without adding additional dispersant molecules. The stabilization of AgNW networks was achieved by minimizing the joule heating at the NW-NW junction assisted by in-situ interconnection with the work function modulated SWCNTs. We propose that the electrical transportation pathway was modulated by the SWCNTs through the SWCNT-AgNW junctions, which results in a relatively lower junction resistance than the NW-NW junction in the network film.
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.
We prove that, for simple modules
over a quantum affine algebra, their tensor product
has a simple head and a simple socle if
is simple. A similar result is proved for the convolution product of simple modules over quiver Hecke algebras.
There is increasing evidence of a relationship between underweight or obesity and dementia risk. Several studies have investigated the relationship between body weight and brain atrophy, a pathological change preceding dementia, but their results are inconsistent. Therefore, we aimed to evaluate the relationship between body mass index (BMI) and cortical atrophy among cognitively normal participants.
We recruited cognitively normal participants (n = 1,111) who underwent medical checkups and detailed neurologic screening, including magnetic resonance imaging (MRI) in the health screening visits between September 2008 and December 2011. The main outcome was cortical thickness measured using MRI. The number of subjects with five BMI groups in men/women was 9/9, 148/258, 185/128, 149/111, and 64/50 in underweight, normal, overweight, mild obesity, and moderate to severe obesity, respectively. Linear and non-linear relationships between BMI and cortical thickness were examined using multiple linear regression analysis and generalized additive models after adjustment for potential confounders.
Among men, underweight participants showed significant cortical thinning in the frontal and temporal regions compared to normal weight participants, while overweight and mildly obese participants had greater cortical thicknesses in the frontal region and the frontal, temporal, and occipital regions, respectively. However, cortical thickness in each brain region was not significantly different in normal weight and moderate to severe obesity groups. Among women, the association between BMI and cortical thickness was not statistically significant.
Our findings suggested that underweight might be an important risk factor for pathological changes in the brain, while overweight or mild obesity may be inversely associated with cortical atrophy in cognitively normal elderly males.
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.
Band contrast (BC) is a qualitative measure of electron back-scattered diffraction (EBSD), which is derived from the intensity of the Kikuchi bands. The BC is dependent upon several factors including scanning electron microscope measurement parameters, EBSD camera setup, and the specimen itself (lattice defect and grain orientation). In this study, the effective factors for BC variations and the feasibility of using BC variations for the quantification of microstructure evolutions have been investigated. In addition, the effects of the lattice defect and the grain orientation on the BC variations are studied. Next, a shear-deformed microstructure of 316L stainless steel, which contains nanosized grains and a large portion of twin boundaries, is revealed by BC map and histogram. Recovery and recrystallization of shear-deformed 316L stainless steel are displayed by BC variations during isothermal annealing at 700 and 800°C, respectively. It is observed that the BC turns bright as the shear-deformed crystal structure is recovered or recrystallized.
We investigated the pressure dependence of the inductive coupled plasma (ICP) oxidation on the electrical characteristics of the thin oxide films. Activation energies and electron temperatures with different pressures were estimated. To demonstrate the pressure effect on the plasma oxide quality, simple N type metal-oxide-semiconductor (NMOS) transistors were fabricated and investigated in a few electrical properties. At higher pressure than 200mTorr, plasma oxide has a slightly higher on-current and a lower interfacial trap density. The on-current gain seems to be related to the field mobility increase and the lower defective interface to the electron temperature during oxidation.
Poly Si1−xGex films have been suggested as a promising alternative to the currently employed poly-Si gate electrode for CMOS technology due to lower resistivity, less boron penetration, and less gate depletion effect than those of poly Si gates. We investigated the formation of poly Si1−xGex films grown by UHV CVD using Si2H6 and GeH4 gases, and studied their microstructures as well as their electrical characteristics. The Ge content of the Si1−xGex films increased linearly with the flux of the GeH4 gas up to x=0.3, and saturated above x=0.45. The deposition rate of the poly Si1−xGex films increased linearly with the flux of the GeH4 gas up to x=0.1, above which it is slightly changed. The resistivity of the Si1−xGex films decreased as the Ge content increased, and was about one half of that of poly-Si films at the Ge content of 45%. The C-V measurements of the MOSCAP structures with poly Si1−xGex gates demonstrated that the flat band voltage of the poly Si1−xGex films was lower than that of poly-Si films by 0.2V.
RF MEMS(Micro-Electro-Mechanical-System) switch technology is one of powerful solution for future RF systems. This technology provides low insertion loss, High linearity and broad bandwidth. Wide driving membrane used MEMS switch can reduce driving voltage but it is easy to bend because of the stress gradient. In order to solve this problem we fabricated Au cantilever in various sputtering condition and various substrate materials. As a result of this experiment, we fabricated cantilever which was bent within 1 um, with 2 um thickness and 340 um length. We applied this condition to RF MEMS switch and we fabricated switch membrane within 1 um bend, under 10MPa stress gradient.
Ferroelectric BaTiO 3 thin films with perovskite structure were grown by sol-gel spin-on processing onto (111)Pt/Ti/SiO2/Si substrates. In order to investigate the effects of space charge in BaTiO3 thin films, we measured the relative dielectric constant and the ac conductivity of the films as a function of frequency, ac oscillation amplitude and temperature. Dielectric constant and dielectric loss were 147 and 0.03 at 100 kHz, respectively. Also, BaTiO3 thin films exhibited marked dielectric relaxation above the Curie temperature and in the low frequency region below 100 Hz. This low frequency dielectric relaxation is attributed to the ionized space charge carriers such as oxygen vacancies and defects in BaTiO3 film and the interfaical polarization. The thermal activation energy for the relaxation process of the ionized space charge carriers was 0.72 eV.
The effects of ternary element addition of manganese on microstructure and mechanical properties of nanocrystalline L12 (Al+X at.%Mn)3Ti (X=0 - 12) fabricated by mechanical alloying and spark plasma sintering (SPS) were investigated. The SPS method was used to consolidate nanocrystalline L12 (Al+X at.%Mn)3Ti with the pressure of 50 MPa. The heating rate was 100°C /min. The final sintering temperature was determined from the observation of the shrinkage of the specimen. In binary Al3Ti, the final sintering temperature was 864°C. The sintering temperature was reduced down to 658°C with increasing Mn concentration. After SPS, the L12 structure was maintained in the specimens which contained Mn concentration of 8- 12 at.%. The microhardness test, grain size measurements, and fracture toughness test were conducted as a function of Mn concentration. In order to investigate the effect of the grain size on the microhardness and fracture toughness of the (Al+8 at.%Mn)3Ti, heat treatments were performed in a vacuum furnace ( 10-3 torr ). With increasing heat treatment temperature, the microhardness decreased due to the formation and growth of Al4C3, Al2O3, and TiC, while fracture toughness increased. The fracture toughness of 4.12 MPa m1/2 was attained for the (Al+8 at.%Mn)3Ti specimen and it was the highest value among the specimens after 1h heat treatment at 1100°C. The grain sizes were about 60 nm and 100 nm after 1 h heat treatment at 900°C and 1100°C, respectively.
Conventional Ge2Sb2Te5 (GST) was modified by adding up a small amount of SiOx, using co-sputtering technique from multiple targets. The SiOx content was gradually increased by increasing the power applied to SiOx target, up to 8 volume percent. The sheet resistance of SiOx-containing GST exponentially increased, when the room-temperature-deposited samples were annealed at 300 °C. Transmission electron microscopy images revealed that no SiOx particulates were formed, which was confirmed by Gattan image filtering. It was indicated by x-ray diffraction patterns that the grain size of SiOx-containing GST is smaller than normal GST with lattice locally distorted at its crystalline state, suggesting that molecular SiOx is homogeneously distributed throughout the GST matrix. We observed that the crystallization temperature of SiOx-containing GST is gradually elevated by increasing the SiOx content, while the melting point decreased. These observations led to the reset current reduction, which is a critical requirement for the high density PRAM.
To improve the IPD reliability of NAND flash memory, plasma oxidation was introduced as the post-treatment process of ONO (Oxide/Nitride/Oxide) IPD. The LP-CVD SiO2 modified by plasma oxidation showed the excellent electrical properties. e.g., low leakage current, high breakdown voltage etc. By the analysis of Tof-SIMS and XRR, we could observe the several changes of physical characteristics such as the reduction of impurities (H, N etc.), the increase of oxide density, and the improvement of oxide surface roughness. We found out the appropriate treatment condition to be able to densify oxide layer without the addition of ONO Equivalent Oxide Thickness (EOT). The LP-CVD SiO2 prepared by plasma oxidation was used for the ONO IPD of 50nm NAND flash device and also compared with the conventional LP-CVD SiO2 in the aspect of the IPD reliability.
We describe Poincaré–Birkhoff–Witt bases for the two-parameter quantum groups U = Ur,s(sln) following Kharchenko and show that the positive part of U has the structure of an iterated skew polynomial ring. We define an ad-invariant bilinear form on U, which plays an important role in the construction of central elements. We introduce an analogue of the Harish-Chandra homomorphism and use it to determine the centre of U.