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Functional impairment in daily activity is a cornerstone in distinguishing the clinical progression of dementia. Multiple indicators based on neuroimaging and neuropsychological instruments are used to assess the levels of impairment and disease severity; however, it remains unclear how multivariate patterns of predictors uniquely predict the functional ability and how the relative importance of various predictors differs.
Method:
In this study, 881 older adults with subjective cognitive complaints, mild cognitive impairment (MCI), and dementia with Alzheimer’s type completed brain structural magnetic resonance imaging (MRI), neuropsychological assessment, and a survey of instrumental activities of daily living (IADL). We utilized the partial least square (PLS) method to identify latent components that are predictive of IADL.
Results:
The result showed distinct brain components (gray matter density of cerebellar, medial temporal, subcortical, limbic, and default network regions) and cognitive–behavioral components (general cognitive abilities, processing speed, and executive function, episodic memory, and neuropsychiatric symptoms) were predictive of IADL. Subsequent path analysis showed that the effect of brain structural components on IADL was largely mediated by cognitive and behavioral components. When comparing hierarchical regression models, the brain structural measures minimally added the explanatory power of cognitive and behavioral measures on IADL.
Conclusion:
Our finding suggests that cerebellar structure and orbitofrontal cortex, alongside with medial temporal lobe, play an important role in the maintenance of functional status in older adults with or without dementia. Moreover, the significance of brain structural volume affects real-life functional activities via disruptions in multiple cognitive and behavioral functions.
The complete chloroplast (cp) genome sequences of three Amaranthus species (Amaranthus hypochondriacus, A. cruentus and A. caudatus) were determined by next-generation sequencing. The cp genome sequences of A. hypochondriacus, A. cruentus and A. caudatus were 150,523, 150,757 and 150,523 bp in length, respectively, each containing 84 genes with identical contents and orders. Expansion or contraction of the inverted repeat region was not observed among the three Amaranthus species. The coding regions were highly conserved with 99.3% homology in nucleotide and amino acid sequences. Five genes – matK, accD, ndhJ, ccsA and ndhF – showed relatively high non-synonymous/synonymous values (Ka/Ks > 0.1). Sequence comparison identified two insertion/deletion (InDels) greater than 40 bp in length, and polymerase chain reaction markers that could amplify these InDel regions were applied to diverse Korean Genbank accessions, which could discriminate the three Amaranthus species. Phylogenetic analyses based on 62 protein-coding genes showed that the core Caryophyllales were monophyletic and Amaranthoideae formed a sister group with the Betoideae and Chenopodioideae clade. Comparing each homologous locus among the three Amaranthus species, identified eight regions with high Pi values (>0.03). Seven of these loci, except for rps19-trnH (GUG), were considered to be useful molecular markers for further phylogenetic studies.
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)
The present study was performed to investigate whether breast-feeding is associated with early pubertal development among children 7–9 years old in Korea.
Design
Children were divided into those who did and did not receive breast-feeding for 6 months or longer in accordance with the recommendations of the WHO. Pubertal status was determined by clinical examination using Tanner staging.
Setting
Prospective observational study.
Subjects
We conducted a follow-up study of children aged 7–9 years in 2011 who had taken part in the Ewha Birth & Growth Cohort study.
Results
Fifty (22·8 %) of the total of 219 children were in early puberty, with the proportion being slightly higher for girls (24·1 %) than boys (21·4 %). Children who had entered early puberty were taller, weighed more and had a higher concentration of insulin-like growth factor 1. Moreover, the change in weight Z-score from birth to follow-up was significantly lower in children who were breast-fed than in those who were not (weight Z-score change: 0·32 (sd 1·59) v. 0·77 (sd 1·61), respectively, P=0·04). Comparison of breast-feeding by puberty status indicated a preventive association with early puberty in children who were breast-fed for 6 months or longer (OR=0·37; 95 % CI 0·18, 0·74). This association remained significant after adjustment for relevant covariates.
Conclusions
These results demonstrate a beneficial association between breast-feeding and early pubertal development, especially in those breast-fed for 6 months or longer. The study suggests that interventions would need to start early in life to prevent early pubertal development.
Three-dimensional (3D) data processing has applications in solving complex tasks such as object recognition, environment modeling, and robotic mapping and localization. Because using raw 3D data without preprocessing is very time-consuming, extraction of geometric features that describe the environment concisely is essential. In this sense, a plane can be a suitable geometric feature due to its simplicity of extraction and the abundance in indoor environments. This paper presents an online incremental plane extraction method using line segments for indoor environments. Our data collection system is based on a “nodding” laser scanner, so we exploit the incremental nature of its data acquisition in which physical rotation and 3D data processing are conducted in parallel. Line segments defined by two end points become supporting elements that comprise a plane, so a large proportion of scan points can be ignored once the line segments are extracted from each scan slice. This elimination of points reduces the algorithm complexity and computation time. Experiments with the tens of complete scan data sets which were acquired from a typical indoor environment demonstrated that our method was at least three times faster than the state-of-the-art methods.
The microstructural analysis of the dehydrogenation products of the Ca(BH4)2–MgH2 composite was performed using transmission electron microscopy. It was found that nanocrystalline CaB6 crystallites formed as a dehydrogenation product throughout the areas where the signals of Ca and Mg were simultaneously detected, in addition to relatively coarse Mg crystallites. The uniform distribution of the nanocrystalline CaB6 crystallites appears to play a key role in the rehydrogenation of the dehydrogenation products, which implies that microstructure is a crucial factor determining the reversibility of reactive hydride composites.
The crystallization of amorphous silicon thin films by electron beam exposure was studied. Amorphous silicon and silicon dioxide layers were deposited on glass substrate by PECVD at 360 °C. The optimization to crystallize 300 nm thick amorphous silicon film was carried out at a RF power of 300 W, DC voltage of 1500 V, Argon gas flow rate of 3 sccm and a distance between electron beam mesh and sample of 40 mm. High quality nano-crystalline silicon films with an activation energy of 0.47 eV from conductivity, a grain size of 15–45 nm from SEM and Raman crystalline volume fraction of 93.1% were fabricated. We expect that e-beam exposure will be applied to crystallization of amorphous silicon films.
The hardness changes caused by formation of the metastable and stable phases were examined and correlated with the microstructural changes in grain interior and grain boundary during aging at 350 °C to clarify the age-hardening and softening mechanism of a low-gold Au-Cu-Ag-Pd dental alloy. Aging in this context refers to the time-delay that occurs wherein such alloys are kept at elevated temperatures for periods upto many hours to allow precipitation or ordering to take place. During the period of increasing hardness, the matrix was separated into the Ag-rich α1 and AuCu I phases through the metastable phases, forming block-like structure. The apparent hardening was attributed primarily to lattice strain due to the tetragonality of AuCu I′ [the primer (′) here indicates a metastable phase; likewise (I) and (I′) indicate stable AuCu I and metastable AuCu I′ phases, respectively] and AuCu I phases along the c-axis, secondarily to the coherency or semicoherency strain between the metastable α1′ and AuCu I′ phases and between the α0 and AuCu I phases along the a-axis. The apparent softening was caused primarily by growth and coarsening of the lamellar structure in the grain boundaries, secondarily by coarsening of the block-like structure in the grain interior.
The prevalence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strains causing bloodstream infection (BSI) has not been studied in Korea.
Objective.
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.
Methods.
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.
Results.
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.
Conclusions.
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.
To describe the incidence of recovery of both vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA) from culture of a single clinical specimen, to describe the clinical characteristics of patients from whom these specimens were recovered, and to identify the risk factors of these patients.
Design.
A retrospective cohort and case-control study.
Setting.
A tertiary care university hospital and referral center in Seoul, Korea.
Methods.
We identified 61 case patients for whom a single clinical specimen yielded both VRE and MRSA on culture, and 122 control patients for whom any clinical specimen yielded only VRE on culture. The control patients were selected by matching 2 :1 with the case patients for age, sex, and first date of sampling that led to isolation of VRE or both VRE and MRSA among 1,536 VRE-colonized patients from January 1, 2003, through December 31, 2006. To identify patient risk factors for the recovery of both VRE and MRSA in a single clinical specimen, we performed univariate comparisons between the 2 groups and then multivariate logistic regression analysis.
Results.
The incidence of recovery of both VRE and MRSA from culture of a single clinical specimen was 3.97% (for 61 of 1,536 VRE-colonized patients) over 4 years. Among these 82 single clinical specimens, the most common type was wound specimens (26.8%), followed by lower respiratory tract specimens (18.3%), urine specimens (17.1%), and catheter tips (15.9%). Of the 61 case patients, 14 (23.0%) had 2 or more single clinical specimens that yielded both VRE and MRSA on culture, and the longest interval from the first sampling that yielded both organisms to the last sampling that yielded both was 174 days. Independent patient risk factors for the presence of both VRE and MRSA in a single clinical specimen were chronic renal disease (odds ratio [OR], 7.00; P = .012), urinary catheterization (OR, 3.36; P = .026), and longer total cumulative duration of hospital stay within the previous year (OR, 1.03; P < .001).
Conclusion.
We confirmed that the recovery of VRE and MRSA from a single clinical specimen occurs continually. Because prolonged cell-to-cell contact can facilitate transfer of vanA, close observation and surveillance for vancomycin-resistant S. aureus, especially among patients with risk factors for the recovery of both VRE and MRSA from a single clinical specimen, should be continued.
To evaluate the economic and clinical impact of infection with extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella species (ESBL-EK).
Design.
A matched-cohort analysis of the cost of illness.
Setting.
An 810-bed, urban, community hospital in Hartford, Connecticut.
Patients.
Twenty-one case patients infected with ESBL-EK at a site other than the urinary tract were matched with 21 control subjects infected with a non–ESBL-producing organism on the basis of pathogen species, age, anatomic site of infection, hospitalization in the intensive care unit (ICU) during the time of infection, date of hospitalization, and initial antibiotics received.
Results.
Mean infection-related costs per patient were significantly greater for case patients than for control patients ($41,353 vs $24,902; P = .034). Infection-related length of stay was the main driver of cost, which was prolonged for case patients, compared with control patients (21 vs 11 days; mean difference, 9.7 days [95% confidence interval {CI}, 3.2-14.6 days] P = .006). The additional cost attributed to the presence of an ESBL-EK infection was $16,450 per patient (95% CI, $965-$31,937). Case patients were more likely than control patients to have clinical failure (P = .027), and the rate of treatment success for case patients whose initial treatment involved antibiotics other than carbapenems was lower than that for their matched control patients (39% vs 83%; P = .013). Treatment was successful in patients for whom initial treatment was with a carbapenem, regardless of the ESBL status of the pathogen.
Conclusion.
The cost of non–urinary tract infections caused by ESBL-EK was 1.7 times the cost of non–urinary tract infections caused by non-ESBL producers. Prompt recognition and appropriate antimicrobial selection may minimize this ESBL-related impact on hospital costs.
(001) oriented (Ba, Sr)TiO3 (BST) thin films were deposited on MgO (001) single crystal substrates by the pulsed laser deposition method. Structural properties of BST films were investigated using X-ray diffractometer. Coplanar waveguide (CPW) device based on BST/MgO layer structure was fabricated by dc sputtering deposition, photolithography and etching process. To study the geometrical factor dependent microwave performance of the CPW phase shifter based on (001) oriented BST film, the CPW devices having various gap and width were fabricated. The microwave dielectric properties of BST CPW phase shifter devices were examined by calculating the scattering parameter obtained using a HP 8510C vector network analyzer with the frequency range 0.5 ∼ 20 GHz at room temperature under the dc bias field of 0 ∼ 40V. The measured return loss and insertion loss at 10 GHz with no dc bias were about -12 ∼ -4 dB and -14 ∼ -3 dB, respectively, which mainly depended on the impedances of the CPW transmission lines. The measured differential phase shift values were about 20 ° ∼ 140 ° at 10 GHz with 40 V dc bias variations, which depended on the gap size.
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.
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.
Microwave properties of coplanar waveguide (CPW) transmission lines fabricated on high dielectric materials, such as ferroelectric Ba1−xSrxTiO3 films, are highly sensitive on the dimension and shape of electrodes. A small change in device dimension affects the total electrical length of the CPW, which may mislead the effective dielectric constant of the dielectric layer. Furthermore, extracting dielectric constant of high-k thin films from the measured microwave properties, such as S-parameters, is very difficult. The well known a modified conformal mapping method frequently exhibits an inconsistent dielectric constant for CPW on high-k materials. CPW transmission lines were fabricated on high-k thin films, ferroelectric Ba0.6Sr0.4TiO3, which were deposited by the pulsed laser deposition with partial oxygen backgrounds. A large phase shift angle of 100° at 10 GHz was observed from the CPW (gap = 4 μm, length = 3 mm) with a 40 V of dc bias, which supports that the idea of the tunable microwave device application using ferroelectrics films. The dielectric constant of the thin ferroelectric film was extracted from the dimension of the CPW (gap, width, length) and the measured S-parameters by a modified conformal mapping. However, the dielectric constant of the ferroelectric thin film calculated by a modified conformal mapping exhibits a gap dependency; dielectric constant (990 ∼ 830) decreases with increasing gap size (4 ∼ 19 μm, respectively). For comparison, dielectric properties have been extracted by extensive EM-simulation using a HFSS™ (Ansoft) with observed dimensions of CPW devices. Total phase, which is closely related with the dielectric constant of the film, is strongly affected by gap size, film thickness, and slanted angle of CPW.
An ultra-low temperature (< 200°C) polycrystalline silicon (poly-Si) film is fabricated for the plastic substrate application using inductively coupled plasma chemical vapor deposition (ICP-CVD) and excimer laser annealing. The precursor active layer is deposited using the SiH4/He mixture at 150°C (substrate). The deposited silicon film consists of crystalline component as well as hydrogenated amorphous component. The hydrogen content in the precursor layer is less than 5 at%. The grain size of the precursor active silicon film is about 200nm and it is increased up to 500nm after excimer laser irradiation.
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.
We investigated the structural evolution of the Ni/Au contact on GaN(000l) during annealing in N2, using in-situ x-ray diffraction, anomalous x-ray scattering, and high resolution electron microscopy. GaN decomposition occurred mostly along GaN dislocations at temperature higher than 500°C. The decomposed Ga diffused into Au and Ni substitutional positions, and the decomposed nitrogen reacted with Ni, forming Ni4N. Interestingly, Ni4N was grown epitaxially. The epitaxial relationship of the Ni4N, Au, and Ni was identified as M(111)//GaN(0002) and M[1 −1 0]//GaN[1 1 −2 0] (M= Ni4N, Au, and Ni). At dislocation free regions, however, the atomically smooth interface remained intact up to 700 °C. Remarkable improvement of device reliability is expected in the contact on dislocation free regions compared with the contact on dislocations.
We investigated the structural behavior of the Ni/Au contact on GaN(000l) during annealing in N2, using in-situ x-ray diffraction, anomalous x-ray scattering, and high resolution electron microscopy. Thermally activated atomic mobility caused the two metal atoms, Au and Ni, to interdiffuse during annealing and form solid solutions. At temperature higher than 500°C, GaN decomposition and reactions occurred mostly along GaN dislocations. By decomposed nitrogen reacted with Ni, interestingly, epitaxial Ni4N phase was formed. The epitaxial relationship of the Ni4N, Au, and Ni was identified as M(111)//GaN(0002) and M[0 1 1]//GaN[0211] (M= Ni4N, Au, and Ni).
Microstructural evolution and mechanical properties of gas-pressure-sintered Si3N4 with 4 wt% Yb2O3 as a sintering aid were investigated. The microstructure was not uniform throughout the specimen. Extremely large elongated grains were formed at the outer region near the surface, while relatively small elongated grains were formed at the inner region of the specimen. The outer region expanded inward with the sintering time. Mechanical properties, such as flexural strength, fracture toughness, and R-curve behavior of the specimens were strongly influenced by these variations in microstructure. The fracture toughness and the R-curve behavior of the outer region were higher than those of the inner region of the same specimen. On the other hand, the strength of the inner region was higher than that of the outer region. By controlling the relative thickness of each region, Si3N4 specimens having functionally graded microstructure were obtained. The Si3N4 with such microstructure exhibited high strength, high fracture toughness, and good flaw tolerance at the same time.