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Over the past two decades, early detection and early intervention in psychosis have become essential goals of psychiatry. However, clinical impressions are insufficient for predicting psychosis outcomes in clinical high-risk (CHR) individuals; a more rigorous and objective model is needed. This study aims to develop and internally validate a model for predicting the transition to psychosis within 10 years.
Methods
Two hundred and eight help-seeking individuals who fulfilled the CHR criteria were enrolled from the prospective, naturalistic cohort program for CHR at the Seoul Youth Clinic (SYC). The least absolute shrinkage and selection operator (LASSO)-penalized Cox regression was used to develop a predictive model for a psychotic transition. We performed k-means clustering and survival analysis to stratify the risk of psychosis.
Results
The predictive model, which includes clinical and cognitive variables, identified the following six baseline variables as important predictors: 1-year percentage decrease in the Global Assessment of Functioning score, IQ, California Verbal Learning Test score, Strange Stories test score, and scores in two domains of the Social Functioning Scale. The predictive model showed a cross-validated Harrell's C-index of 0.78 and identified three subclusters with significantly different risk levels.
Conclusions
Overall, our predictive model showed a predictive ability and could facilitate a personalized therapeutic approach to different risks in high-risk individuals.
In order to maximize the utility of future studies of trilobite ontogeny, we propose a set of standard practices that relate to the collection, nomenclature, description, depiction, and interpretation of ontogenetic series inferred from articulated specimens belonging to individual species. In some cases, these suggestions may also apply to ontogenetic studies of other fossilized taxa.
Background: Data from Clostridium difficile infection (CDI) in neutropenic patients are still scarce. Objective: To assess outcomes of CDI in patients with and without neutropenia. Methods: The study included a retrospective cohort of adult patients at 3 academic hospitals between January 2013 and December 2017. The 2 study arms were neutropenic patients (neutrophil count <500/mm3) and nonneutropenic patients with confirmed CDI episodes. The primary outcome evaluated the composite end point of all-cause in-hospital mortality, intensive care unit (ICU) admissions, and treatment failure at 7 days. The secondary outcome evaluated hospital length of stay. Results: Of 962 unique cases of CDI, 158 were neutropenic (59% men) and 804 were nonneutropenic (46% men). The median age was 57 years (IQR, 44–64) in the neutropenic group and 68 years (IQR, 56–79) in the nonneutropenic group. The median Charlson comorbidity score was 5 (IQR, 3–7.8) and 4 (IQR, 3–5) in the neutropenic and nonneutropenic groups, respectively. Regarding severity, 88.6% versus 48.9% were nonsevere, 8.2% versus 47% were severe, and 3.2% versus 4.1% were fulminant in the neutropenic and nonneutropenic groups, respectively. Also, 63% of patients (60.9% in nonneutropenic, 65.2% in neutropenic) were exposed to proton-pump inhibitors. A combination CDI treatment was required in 53.2% of neutropenic patients and 50.1% of nonneutropenic patients. The primary composite end point occurred in 27% of neutropenic patients versus 22% of nonneutropenic patients (P = .257), with an adjusted odds ratio of 1.30 (95% CI, 0.84–2.00). The median hospital length of stay after controlling for covariates was 21.3 days versus 14.2 days in the neutropenic and nonneutropenic groups, respectively (P < .001). Complications (defined as hypotension requiring vasopressors, ileus, or bowel perforation) were seen in 6.0% of the nonneutropenic group and 4.4% of the neutropenic group (P = .574), with an adjusted odds ratio of 0.61 (95% CI, 0.28–1.45). Conclusions: Neutropenic patients were younger and their cases were less severe; however, they had lower incidences of all-cause in-hospital mortality, ICU admissions, and treatment failure. Hospital length of stay was significantly shorter in the neutropenic group than in the nonneutropenic group.
The aerodynamic characteristics of a hovering rhinoceros beetle are numerically and theoretically investigated. Its wing kinematics is measured using high speed cameras and used for numerical simulations of flow around a flapping rhinoceros beetle in hovering flight. The numerical results show that the aerodynamic forces generated (especially for lift) and power required by the hind wing during a quasi-periodic state are quite different from those during the first stroke. This indicates that the wing–wake interaction significantly affects the aerodynamic performance of the hind wing during the quasi-periodic state. Also, twisting of the hind wing along the wing span direction does not contribute much to total force generation as compared to that of the flat wing, and the role of elytron and body on the aerodynamic performance is quite small, at least for the present hovering flight. Based on a previous model (Wang et al., J. Fluid Mech., vol. 800, 2016, pp. 688–719), we suggest an improved predictive aerodynamic model without any ad hoc model constants for a rigid and flat hind wing by considering the effect of the wing–wake interaction in hovering flight. In this model, we treat the wake as a steady or unsteady non-uniform downwash motion and obtain its magnitude by combining a quasi-steady blade element theory with an inviscid momentum theory. The lift and drag forces and aerodynamic power consumption predicted by this model are in excellent agreement with those obtained from numerical simulations.
We report on the X-ray diffraction data and unit-cell parameters of Mn4C, which has a cubic perovskite-type structure with a = 3.8726 Å and unit-cell volume V = 58.1 Å3. The measured lines were indexed and are consistent with the space group
$ Pm { \bar {\it 3}} m$
(No. 221).
The status of Asian populations of the Eurasian otter Lutra lutra is largely unknown. Since its designation as a Natural Monument (in 1983) and as Endangered (in 1997) in South Korea the authorities there have been trying to conserve and recover the species. We conducted a national otter survey by standard methods in 2017 and compared the current otter distribution to those recorded in a previous survey (2010). We found otter signs in 84.5% of 1,105 10 × 10 km grid cells, with the highest sprainting intensity in the south-west in the Yeongsan River Basin and on the south coast, where we recorded 7.05 and 6.26 spraints/site, respectively. Despite relatively low spraint densities, the otter has expanded its range since 2010 by colonizing urban areas. This trend suggests that South Korea could be a source area for the recovery of the Eurasian otter in East Asia.
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.
Methods
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.
Results
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.
Conclusions
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.
The submarine channel-fill system of the Cambrian Spurs Formation exhibits unique metre-scale cycles of breccia and diamictite. The studied sections, Eureka Spurs, are located at the Mariner Glacier in the central-eastern part of northern Victoria Land, Antarctica. A facies analysis of the channel-fill deposit has led to the recognition of four main lithofacies: breccia, diamictite, thin-bedded sandstone and mudstone. The channel-fill deposit consists of two architectural elements: hollow-fill (HF) and sheet-like (SL) elements. The SL has wide convex-up geometry and consists solely of a very thick bed of diamictite, and is interpreted as a submarine channel lobe. The HF has a concave-up erosional base and flat upper surface. The HF consists of nine cyclic alternations of underlying breccia (cohesionless debris flow) and overlying diamictite (cohesive debris flow). The deposition of breccia is interpreted to have been controlled by repeated allogenic processes such as earthquakes. In contrast, the abrupt vertical transition from breccia to diamictite in each cycle is interpreted to have resulted from an autogenic, slope instability-related process. The interaction of the allogenic and autogenic factors recorded in the metre-scale unique cyclic deposits provides new criteria to interpret cycles of submarine debris flow.
We have optimized the input pulse width and injection time to achieve the highest possible output pulse energy in a double-pass laser amplifier using two Nd:YAG rods. For this purpose, we have extended the Frantz–Nodvik equation by simultaneously including both spontaneous emission and pump energy variation. The effective pump energy of the flash lamp was 8.84 J for each gain medium. The energy of 1 J could be amplified to an output energy of 12.17 J with the maximum achieved extraction efficiency of 63.18% when an input pulse having a pulse width of 168
$\unicode[STIX]{x03BC}$
s is sent 10
$\unicode[STIX]{x03BC}$
s after the absorbed pump energy becomes the maximum value.
Two challenges exist in laser-assisted atom probe tomography (APT). First, a drastic decline in mass-resolving power is caused, not only by laser-induced thermal effects on the APT tips of bulk oxide materials, but also the associated asymmetric evaporation behavior; second, the field evaporation mechanisms of bulk oxide tips under laser illumination are still unclear due to the complex relations between laser pulse and oxide materials. In this study, both phenomena were investigated by depositing Ni- and Co-capping layers onto the bulk LaAlO3 tips, and using stepwise APT analysis with transmission electron microscopy (TEM) observation of the tip shapes. By employing the metallic capping, the heating at the surface of the oxide tips during APT analysis became more symmetrical, thereby enabling a high mass-resolving power in the mass spectrum. In addition, the stepwise microscopy technique visualized tip shape evolution during APT analysis, thereby accounting for evaporation sequences at the tip surface. The combination of “capping” and “stepwise APT with TEM,” is applicable to any nonconductors; it provides a direct observation of tip shape evolution, allows determination of the field evaporation strength of oxides, and facilitates understanding of the effects of ultrafast laser illumination on an oxide tip.
Shumardiid trilobites had a small, unique morphology, and formed a key constituent in trilobite faunas during the Cambrian–Ordovician. Because of their unusual morphology, they have been the subject of research s, into various aspects such as their life habit, functional morphology, evolutionary origin and ontogeny. Originally, a flat, adult-like protaspid morphology was suggested for shumardiids, but subsequently a bulbous protaspid morphology interpreted to be associated with metamorphosis was also suggested for this unique trilobite group. This article documents the ontogeny of the two co-occurring shumardiid trilobites, Akoldinioidia latus Park and Kihm and Koldinioidia choii Park and Kihm, from the middle Furongian Hwajeol Formation, Taebaeksan Basin, Korea. Interestingly, protaspides of the two shumardiids have a bulbous morphology. Given the stratigraphic occurrences of the two shumardiids, it can be inferred that commutavi protaspis appeared quite early in the shumardiid evolution. The co-occurrence of the two closely related trilobites is reminiscent of sexual dimorphism, although further evidence is required to prove it. The appearance of metamorphosis-undergoing protaspides in the Furongian shumardiids may have been due to the onset of increasing ecological pressure in the early phase of the Great Ordovician Biodiversification Event.
This study aimed to investigate the relationship between the unemployment experience and depressive symptoms among mid-aged (ages 45–59) and elderly (ages 60 or above) persons and to examine further the effects of unemployment insurance, industrial accident compensation insurance (IACI) and national pension on the stated relationship. Data were used from the Korean Longitudinal Study of Aging (KLoSA) between 2006 and 2012. A total of 1,536 individuals employed at the 2006 baseline were followed. The association between employment status change during 2006 to 2008, 2008 to 2010 or 2010 to 2012 and depressive symptoms in years 2008, 2010 or 2012 were analysed using a generalised estimating equation model. Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale (CES-D 10) scale. The results showed that the ‘employed to unemployed’ group had statistically significant increases in depression scores in the mid-aged (β = 0.4884, p = 0.0038) and elderly (β = 0.8275, p ⩽ 0.0001) categories, compared to the ‘employed to employed’ group. Findings were maintained in groups without a social safety net. Contrastingly, the ‘employed to unemployed’ groups with unemployment insurance and IACI did not show statistically significant increases in depression scores. The ‘employed to unemployed’ category of individuals enrolled in the national pension system exhibited a lower increase of depression. Therefore, an enhanced focus on the mental health of unemployed individuals is required, in addition to the provision of a reliable social safety net.
Noticeable demographic changes have taken place in South Korea, with the general marriage rate decreasing and the average first age at marriage and general divorce rate increasing. The shown trends have contributed to intergenerational discordance in the perception of familial values, which is important in addressing the psychological well-being of parents. This study aimed to investigate the association between the marital status of offspring aged 40 years and over and the depression levels of parents.
Methods:
Data were from the Korean Longitudinal Study of Aging (KLoSA), 2006–2012. A total of 2,540 individuals with at least two offspring aged 40 years and over were included. Association between offspring marital status and parental depression scores, measured using the Center for Epidemiological Studies and Depression (CES-D 10) scale, was investigated using the generalized estimating equation (GEE) model. Subgroup analysis was performed based on offspring education level.
Results:
When parents with only married offspring were set as reference, parents with never married offspring (β: 0.27, p = 0.02), parents with separated offspring (β: 0.52, p = 0.03), and parents with never married offspring and separated offspring (β: 0.38, p < 0.001) showed increases in depression scores. In the subgroup analysis, these higher depression score effects were largely limited to parents with high school graduate offspring.
Conclusion:
It is important to monitor the mental health status of parents with never married, separated, or both never married and separated offspring as this group may be comparatively vulnerable to depressive symptoms.
Echinochloa species are among the most troublesome weeds in
rice cultivation, and grow in a broad habitat range in Korea. Although
various ecotypes of Echinochloa have been collected as
germplasm for future studies, it has been difficult to classify them due to
their high level of morphological similarity. This study was thus conducted
to develop and investigate the phylogenetic relationships between 77
Echinochloa accessions with the use of 23 simple
sequence repeat (SSR) markers and 24 morphological traits. Of 77
Echinochloa accessions, including 57 accessions from
Korea and 5 reference species, late watergrass was clearly clustered as a
distinctive group from barnyardgrass and other Echinochloa
species. In this analysis, we also identified core genetic and morphological
markers that can be used for the future identification and classification of
Echinochloa species. Five out of 23 SSR makers produced
distinctive bands that discriminate late watergrass from barnyardgrass and
other Echinochloa species. Four morphological traits of the
reproductive organs were the most influential contributors for classifying
Echinochloa species. Although there was no clear
consensus generated in this study between SSR markers and morphological
trait analyses, our results support the potential use of the selected SSR
markers and morphological traits in future studies of
Echinochloa.
Suicide rates are high among elderly individuals experiencing socioeconomic insecurity. Socioeconomic security is of critical importance for elderly individuals and directly affects mental health, including suicidal behavior. Thus, we investigated the relationship between socioeconomic status and suicidal ideation in elderly individuals.
Method:
We conducted a cross-sectional study using data on 58,590 individuals 65 years of age or older from the Korean Community Health Survey 2013. Logistic regression analysis was used to identify relationships between socioeconomic factors (food insecurity, household income, and living arrangement) and suicidal ideation in the elderly population.
Results:
The study included 58,590 participants (24,246 males and 34,344 females). Of those, 2,847 males and 6,418 females experienced suicidal ideation. Participants with food insecure were more likely to experience suicidal ideation than were those who were food secure (males: OR = 1.60; 95% CI, 1.34–1.90; females: OR = 1.54; 95% CI, 1.38–1.72). We found a similar pattern among participants with a low household income and those living alone. Additionally, male and female subjects who were food insecure and living alone or food insecure and had a low household income showed a marked increase in suicidal ideation.
Conclusion:
Our findings suggest that low socioeconomic status is associated with an increased risk of suicidal ideation among the elderly. Furthermore, intervention programs that address the prevalence of elderly suicide, particularly among those who are socioeconomically disadvantaged, are needed.