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It has been suggested that psychosocial factors are related to survival time of inpatients with cancer. However, there are not many studies examining the relationship between spiritual well-being (SWB) and survival time among countries. This study investigated the relationship between SWB and survival time among three East Asian countries.
This international multicenter cohort study is a secondary analysis involving newly admitted inpatients with advanced cancer in palliative care units in Japan, South Korea, and Taiwan. SWB was measured using the Integrated Palliative Outcome Scale (IPOS) at admission. We performed multivariate analysis using the Cox proportional hazards model to identify independent prognostic factors.
A total of 2,638 patients treated at 37 palliative care units from January 2017 to September 2018 were analyzed. The median survival time was 18.0 days (95% confidence interval [CI] 16.5–19.5) in Japan, 23.0 days (95% CI 19.9–26.1) in Korea, and 15.0 days (95% CI 13.0–17.0) in Taiwan. SWB was a significant factor correlated with survival in Taiwan (hazard ratio [HR] 1.27; 95% CI 1.01–1.59; p = 0.04), while it was insignificant in Japan (HR 1.10; 95% CI 1.00–1.22; p = 0.06), and Korea (HR 1.02; 95% CI 0.77–1.35; p = 0.89).
Significance of results
SWB on admission was associated with survival in patients with advanced cancer in Taiwan but not Japan or Korea. The findings suggest the possibility of a positive relationship between spiritual care and survival time in patients with far advanced cancer.
Accurate prognostication is important for patients and their families to prepare for the end of life. Objective Prognostic Score (OPS) is an easy-to-use tool that does not require the clinicians’ prediction of survival (CPS), whereas Palliative Prognostic Score (PaP) needs CPS. Thus, inexperienced clinicians may hesitate to use PaP. We aimed to evaluate the accuracy of OPS compared with PaP in inpatients in palliative care units (PCUs) in three East Asian countries.
This study was a secondary analysis of a cross-cultural, multicenter cohort study. We enrolled inpatients with far-advanced cancer in PCUs in Japan, Korea, and Taiwan from 2017 to 2018. We calculated the area under the receiver operating characteristics (AUROC) curve to compare the accuracy of OPS and PaP.
A total of 1,628 inpatients in 33 PCUs in Japan and Korea were analyzed. OPS and PaP were calculated in 71.7% of the Japanese patients and 80.0% of the Korean patients. In Taiwan, PaP was calculated for 81.6% of the patients. The AUROC for 3-week survival was 0.74 for OPS in Japan, 0.68 for OPS in Korea, 0.80 for PaP in Japan, and 0.73 for PaP in Korea. The AUROC for 30-day survival was 0.70 for OPS in Japan, 0.71 for OPS in Korea, 0.79 for PaP in Japan, and 0.74 for PaP in Korea.
Significance of results
Both OPS and PaP showed good performance in Japan and Korea. Compared with PaP, OPS could be more useful for inexperienced physicians who hesitate to estimate CPS.
Several studies on the treatment of coronavirus disease 2019 (COVID-19) are being conducted, and various drugs are being tried; however, the results have not been uniform. Steroids have been widely used in the treatment of COVID-19, but their effects are controversial. As immunosuppressive and anti-inflammatory agents, steroids are considered to reduce lung damage by regulating various inflammatory responses. We report a case of severe acute respiratory syndrome coronavirus-2 pneumonia manifesting as a cryptogenic organizing pneumonia-like reaction and discuss its treatment, clinical course, and favorable outcomes after steroid administration.
N-terminal pro-B-type natriuretic peptide (NT-proBNP), a well-known marker of cardiac disease, may be elevated in acute infections and other non-cardiac diseases. The aim of this study was to evaluate NT-proBNP levels in cardiac and non-cardiac diseases and found out the patient’s clinical status that affects the NT-proBNP levels.
NT-proBNP levels were measured in three groups of children: a cardiac disease group, an infectious disease group, and a non-cardiac, non-infectious disease group.
In total, 348 children were enrolled, including 134 patients (38.5%) with cardiac disease, 170 patients (48.9%) with infectious disease, and 44 patients (12.6%) with non-cardiac, non-infectious disease. The NT-proBNP level of the cardiac disease group (median: 548 pg/mL; range: 5–35,000 pg/mL) was significantly higher than that of the infectious disease group (median: 193 pg/mL; range: 10–35,000 pg/mL) and the non-cardiac, non-infectious disease group (median: 280 pg/mL; range: 6–35,000 pg/mL). Regarding clinical status, the NT-proBNP levels were significantly higher in patients who needed mechanical ventilation support, oxygen therapy, or inotropic medication or had a change in mental status than in other patients. However, the systemic inflammatory response syndrome and mortality were not related to the NT-proBNP level.
Among heterogeneous group of children, NT-proBNP level can be a useful marker of cardiac disease. Furthermore, the NT-proBNP levels were related to patients’ clinical deteriorations, such as shock rather than the inflammatory status of patients.
We investigated potential nosocomial aerosol transmission of severe fever with thrombocytopenia syndrome virus (SFTSV) with droplet precautions. During aerosol generating procedures, SFTSV was be transmitted from person to person through aerosols. Thus, airborne precautions should be added to standard precautions to avoid direct contact and droplet transmission.
Following ovulation, oocytes undergo a time-dependent deterioration in quality referred to as post-ovulatory ageing. Although various factors influence the post-ovulatory ageing of oocytes, oxidative stress is a key factor involved in deterioration of oocyte quality. Artemisia asiatica Nakai ex Pamp. has been widely used in East Asia as a food ingredient and traditional medicine for the treatment of inflammation, cancer, and microbial infections. Recent studies have shown that A. asiatica exhibits antioxidative effects. In this study, we investigated whether A. asiatica has the potential to attenuate deterioration in oocyte quality during post-ovulatory ageing. Freshly ovulated mouse oocytes were cultured with 0, 50, 100 or 200 μg/ml ethanol extracts of A. asiatica Nakai ex Pamp. After culture for up to 24 h, various ageing-induced oocyte abnormalities, including morphological changes, reactive oxygen species (ROS) accumulation, apoptosis, chromosome and spindle defects, and mitochondrial aggregation were determined. Treatment of oocytes with A. asiatica extracts reduced ageing-induced morphological changes. Moreover, A. asiatica extracts decreased ROS generation and the onset of apoptosis by preventing elevation of the Bax/Bcl-2 expression ratio during post-ovulatory ageing. Furthermore, A. asiatica extracts attenuated the ageing-induced abnormalities including spindle defects, chromosome misalignment and mitochondrial aggregation. Our results demonstrate that A. asiatica can relieve deterioration in oocyte quality and delay the onset of apoptosis during post-ovulatory ageing.
The HoDoo English game was developed to take advantage of the benefits attributed to on-line games while teaching English to native Korean speakers. We expected to see that the improvements in the subjects’ English language abilities after playing the HoDoo English game would be associated with increased brain functional connectivity in the areas of the brain involved in the language production (Broca’s area) and the understanding (Wernicke’s area) networks. Twelve children, aged nine and ten, were asked to play the on-line English education game for 50 minutes per day, five days per week for twelve weeks. At baseline, and again at the end of twelve weeks of game play, each child’s English language ability was assessed and a functional magnetic resonance imaging (fMRI) scan was conducted. The on-line English education game play effectively improved English language skills, especially in terms of non-verbal pragmatic skills. Following twelve weeks of on-line English education game play, the children showed positive connectivity between Broca’s area and the left frontal cortex as well as between Wernicke’s area and the left parahippocampal gyrus and the right medial frontal gyrus. Changes in pragmatic scores were positively correlated with average peak brain activity in the left parahippocampal gyrus. To the best of our knowledge, this is the first study to report an improvement in English ability and changes in brain activity within language areas after on-line language education game play.
The Sewol ferry disaster is one of the most tragic events in Korea’s modern history. Among the 476 people on board, which included Danwon High School students (324) and teachers (14), 304 passengers died in the disaster (295 recovered corpses and 9 missing) and 172 survived. Of the rescued survivors, 72 were attending Danwon High School, located in Ansan City, and residing in a residence nearby. Because the students were young, emotionally susceptible adolescents, both the government and the parents requested the students be grouped together at a single hospital capable of appropriate psychiatric care. Korea University Ansan Hospital was the logical choice, as the only third-tier university-grade hospital with the necessary faculty and facilities within the residential area of the families of the students. We report the experiences and the lessons learned from the processes of preparing for and managing the surviving young students as a community-based hospital. (Disaster Med Public Health Preparedness. 2017;11:389–393)
Assessment of frontal lobe impairment in amyotrophic lateral sclerosis (ALS) is a matter of great importance, since it often causes ALS patients to decrease medication and nursing compliance, thus shortening their survival time.
The frontal assessment battery (FAB) is a short and rapid method for assessing frontal executive functions. We investigated the applicability of the FAB as a screening method for assessing cognitive impairments in 61 ALS patients. Depending on the results of the FAB, we classified patients into two subgroups: FAB-normal and FAB-abnormal. We then performed additional evaluations of cognitive function using the Korean version of the mini-mental state examination (K-MMSE), a verbal fluency test (COWAT), and a neuropsychiatric inventory (NPI). Results of these tests were compared between the two groups using Mann-Whitney U-tests, and Spearman correlation analyses were used to investigate the relationships between FAB score and disease duration and severity.
Of the 61 sporadic ALS patients included in this study, 14 were classified as FAB-abnormal and 47 were classified as FAB-normal. The FAB-normal and FAB-abnormal patients performed significantly differently in all domains of the COWAT. There was no difference in behavioral disturbance, as assessed by the NPI, between the two groups. The FAB scores were found to significantly correlate with both disease duration and severity.
The FAB shows promise as a method of screening for frontal lobe dysfunction in ALS, as it is not only quick and easy, but also reliable. Additional studies should examine how FAB performance changes as ALS progresses.
It is controversial whether Borna disease virus (BDV) infects humans and causes psychiatric disorders.
The relationship between BDV infection and schizophrenia with deficit syndrome was investigated.
Using the Schedule for the Deficit Syndrome, 62 schizophrenic in-patients were selected from three psychiatric hospitals. RNA was extracted from peripheral blood mononuclear cells and analyzed using nested reverse transcriptase-polymerase chain reaction with primers to detect BDV p24 and p40.
Results and conclusions:
BDV transcripts were not detected in samples from any of the 62 schizophrenic patients. These data do not support an etiologic association between BDV infection and the deficit form of schizophrenia.
Nanoparticles of Cd1–xCuxS (x = 0–0.15) were synthesized by chemical coprecipitation using thiophenol as a capping agent. The x-ray diffraction patterns reveal that the pure and doped CdS nanoparticles are single phase with cubic zinc blende structure. The transmission electron microscopy shows the average size of the nanoparticles is about 8.5 nm. Optical absorption spectra indicate the energy gap decreases with increasing Cu2+ concentration. The broad emission peak around 520 nm is completely quenched with increasing Cu2+ content. The electron spin resonance analysis also confirms the Cu (II) ion to be doped substitutionally in CdS nanoparticles and the Lande factor of all the samples with sharp resonance is g = 2.0.
The prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains causing bloodstream infection (BSI) has not been studied in Korea.
We sought to determine the prevalence of CA-MRSA strains among isolates recovered from patients with MRSA BSIs and to explore epidemiological changes in Korea. We also sought to evaluate clinical characteristics relevant to the development of healthcare-associated BSIs.
We prospectively collected consecutive MRSA isolates from patients with BSI at 4 hospitals from July 1 through November 30, 2007, and we also included MRSA isolates recovered from culture of blood samples collected during a previous year (October 1, 2004 through September 30, 2005) at a different hospital. Molecular typing studies were performed, including pulsed-field gel electrophoresis (PFGE), multilocus sequence typing, Staphylococcus protein A (spa) typing, and staphylococcal cassette chromosome mec (SCCmec) typing. We compared the clinical characteristics and outcomes of patients with healthcare-associated BSI due to CA-MRSA strains with those of patients with healthcare-associated BSI due to healthcare-associated MRSA (HA-MRSA) strains.
There were 76 cases of MRSA BSI, of which 4 (5.3%) were community-associated and 72 (94.7%) were healthcare-associated. Among the 72 HA-MRSA BSIs, 18 (25%) were community onset, and 54 (75%) were hospital onset. PFGE type D-ST72–spa B-SCCmec type IVA MRSA, the predominant genotype of CA-MRSA in Korea, accounted for 19 (25%) of all 76 MRSA BSIs, including 17 (23.6%) of 72 HA-MRSA BSIs and 11 (20.8%) of 53 hospital-onset HA-MRSA BSIs. Patients with healthcare-associated BSIs due to CA-MRSA strains carrying SCCmec type IVA tended to have fewer healthcare-associated risk factors, compared with patients with healthcare-associated BSIs due to HA-MRSA strains carrying other SCCmec types. The presence of a central venous catheter or other invasive device was the only independent factor differentiating patients infected with hospital-associated genotype strains from patients infected with other strains. Clinical outcomes were similar between both groups.
CA-MRSA strains are emerging as a major cause of BSI in healthcare settings in Korea. This changing epidemiology of MRSA poses a challenge to public health and infection control in hospital settings.
Experimental wet chemical approaches to complex an iron atom with two C60 fullerenes, representing a new molecule, dubbed a “bucky dumbbell,” have been demonstrated. The structure of this molecule has been determined by 13C solid-state nuclear magnetic resonance (NMR) and electron paramagnetic resonance (EPR). Furthermore, this structure has been shown to have unique binding sites for dihydrogen molecules with the technique of temperature programmed desorption (TPD). The new adsorption sites have binding energies that are stronger than that observed for hydrogen physisorbed on planar graphite, but significantly weaker than a chemical C-H bond. Further development of these molecules could make them ideal candidates for onboard vehicular hydrogen storage.
Surface acoustic wave (SAW) propagation properties of gallium nitride (GaN) epitaxial layers on sapphire were theoretically and experimentally characterized. GaN thin films were grown on a c-plane sapphire substrate using a metalorganic chemical vapor deposition system. The experimental characterization of SAW propagation properties was performed with a linear array of interdigital transducer structures, while SAW velocities were calculated by matrix methods. Experimentally, we found pseudo-SAW and high-velocity pseudo-SAW modes in the GaN/sapphire structure, which had a good agreement with calculated velocities.
Polysilsesquioxanes (PSSQs) with the empirical formula (RSiO3/2)n have become very important as low-dielectric insulators for copper interconnects in the next-generation logic devices, but the detailed structure-property relationships were completely lacking. We have investigated the microstructure and functional properties of PSSQs with varying alkyl substituents and also PSSQ copolymers. As a result, significant advances have been made in the scientific understanding of PSSQ structures and significant improvements of key properties such as the crack resistance, mechanical modulus and hardness, and incorporation of nanometer-sized (<4 nm) porosity for ultra-low dielectric constants (<2.0).
Effect of SiO2 capping layer(C/L) on recrystallization of amorphous Si (a-Si) film was investigated. When a thick C/L over 500 Å was deposited on an a-Si film before crystallization, fine p-Si grains less than 100nm were obtained at full range of energy density window. However, when a thin C/L below 200 Å was used, Si-melt spouted out through C/L at over critical energy density. When Si-melt started spouting, abrupt change of grain size also occurred. These large grains could be explained by a non-uniformity of heat flow caused by Si-melt spouting. With this polycrystalline Si (p-Si) material having appreciable grain size protected by C/L, fabrication of low-cost Low Temperature Poly Si (LTPS) without additional cleaning of p-Si surface could be successfully developed.
The film properties of WNxCy films deposited by atomic layer deposition (ALD) using WF6, NH3, and triethylboron source gases were characterized as diffusion barrier for Cu metallization. It is noted that the as-deposited film shows an extremely low resistivity of about 350 μΔ-cm with a film density of 15.37 g/cm3. The film composition measured from Rutherford backscattering spectrometry shows W, C, and N of approximately 48, 32, and 20 at.%, respectively. Transmission electron microscopy analyses show that the as-deposited film is composed of face-centered-cubic phase with a lattice parameter similar to both β-WC1-x and β-W2N with an equiaxed microstructure. The barrier property of this ALD-WNxCy film at a nominal thickness of 12 nm deposited between Cu and Si fails only after annealing at 700°C for 30 minutes while the sputter-deposited Ta (12 nm) and ALD-TiN (20 nm) fail at 650 and 600°C, respectively. It is thought that the superior diffusion barrier performance of ALD-WNxCyfilm is the consequence of both nanocrystalline equiaxed grain structure and the formation of high density film.
We have studied infrared photoluminescence (PL) and x-ray diffraction (XRD) of 400 nm and 1500 nm thick InAs epilayers on GaAs, and 4 nm thick InAs on graded InGaAs layer with total thickness of 300 nm grown by molecular beam epitaxy. The PL peak positions of 400 nm, 1500 nm and 4 nm InAs epilayer measured at 10 K are blue-shifted from that of InAs bulk by 6.5, 4.5, and 6 meV, respectively, which can be largely explained by the residual strain in the epilayer. The residual strain caused by the lattice mismatch between InAs and GaAs or graded InGaAs/GaAs was observed from XRD measurements. While the PL peak position of 400 nm thick InAs layer is linearly shifted toward higher energy with increase in excitation intensity ranging from 10 to 140 mW, those of 4 nm InAs epilayer on InGaAs and 1500 nm InAs layer on GaAs is gradually blue-shifted and then, saturated above a power of 75 mW. These results suggest that adopting a graded InGaAs layer between InAs and GaAs can efficiently reduce the strain due to lattice mismatch in the structure of InAs/GaAs.
(200)-oriented Pt thin films were deposited on SiO2/Si substrates by dc magnetron sputtering using Ar/O2 gas mixtures. Oxygen incorporation into Pt films changed deposition rate, resistivity, stress, and preferred orientation of the films. Increase in film resistivity and decrease in tensile stress were presumed to be the results of the incorporated oxygen into grain boundaries, while the change of preferred orientation resulted from the oxygen incorporation into the Pt lattice. The preferential growth of (200) planes with less total strain energy from the incorporated oxygen resulted in strong (200) preferred orientation in Pt films.
Highly (200)-oriented Pt films on SiO2/Si substrates were successfully prepared by a combination of a dc magnetron sputtering using Ar/O2 gas mixtures and subsequent controlled annealing. The intensity ratio of (200) to (111) planes (I200/I111) was over 200. The (200)-oriented Pt microcrystallites were less susceptible to amorphization due to their lower strain energy with oxygen incorporation than (111)-oriented ones. The controlled grain growth from the selected (200)-oriented seed microcrystallites during subsequent annealing provided a kinetic pathway where grain growth of the seed microcrystallites was predominant, while suppressing the nucleation of surface energy-driven, (111)-oriented seed microcrystallites and subsequent (111) preferred orientation.