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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.
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.
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.
Overall, our predictive model showed a predictive ability and could facilitate a personalized therapeutic approach to different risks in high-risk individuals.
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.
Depressive symptoms are common in bereaved caregivers; however, there have been few prospective studies using a structured interview. This study investigated the prevalence and preloss predictors of major depressive disorder (MDD) in bereaved caregivers of patients in a palliative care unit.
This prospective cohort study collected caregiver sociodemographic and psychological data before the death of a palliative care unit patient, including MDD, care-burden, coping style, and hopeful attitude. Postloss MDD was assessed 6 and 13 months after death, and a multivariate logistic regression analysis was conducted to identify its predictors.
Of 305 caregivers contacted, 92 participated in this study. The prevalence of preloss MDD was 21.8%; the prevalences of postloss MDD were 34.8% and 24.7% at 6 and 13 months, respectively. Preloss MDD predicted postloss MDD at 6 months (odds ratio [OR] = 5.38, 95% confidence interval [CI95%] = 1.29, 22.43); preloss nonhopeful attitude and unemployment status of caregivers predicted postloss MDD at 13 months (OR = 8.77, CI95% = 1.87, 41.13 and OR = 7.10, CI95% = 1.28, 39.36, respectively).
Significance of results
Approximately 35% of caregivers suffered from MDD at 6 months postloss, but the prevalence of MDD decreased to about 25% at 13 months. Preloss MDD significantly predicted postloss MDD at 6 months, whereas hopeful attitude and unemployment at baseline were significantly associated with postloss MDD at 13 months.
To determine the influence of caregiver personality and other factors on the burden of family caregivers of terminally ill cancer patients.
We investigated a wide range of factors related to the patient–family caregiver dyad in a palliative care setting using a cross-sectional design. Caregiver burden was assessed using the seven-item short version of the Zarit Burden Interview (ZBI–7). Caregiver personality was assessed using the 10-item short version of the Big Five Inventory (BFI–10), which measures the following five personality dimensions: extroversion, agreeableness, conscientiousness, neuroticism, and openness. Patient- and caregiver-related sociodemographic and psychological factors were included in the analysis because of their potential association with caregiver burden. Clinical patient data were obtained from medical charts or by using other measures. Multivariate linear regression analysis was performed to identify the independent factors associated with caregiver burden.
We analyzed 227 patient–family caregiver dyads. The multivariate analysis revealed that caregiver extroversion was protective against caregiver burden, whereas depressive symptoms in caregivers were related to increased burden. Neuroticism was positively correlated with caregiver burden, but this relationship was nonsignificant following adjustment for depressive symptoms. Patient-related factors were not significantly associated with caregiver burden.
Significance of Results:
Evaluating caregiver personality traits could facilitate identification of individuals at greater risk of high burden. Furthermore, depression screening and treatment programs for caregivers in palliative care settings are required to decrease caregiver burden.
This study aimed to assess the prevalence, incidence, and persistence of suicidal ideation (SI), and to investigate the psychosocial factors associated with these.
A total of 1,204 community dwelling elderly adults aged 65 years or older were evaluated at baseline, 909 (75%) of whom were followed two years later. The presence of SI was identified using the questions from the community version of the Geriatric Mental State (GMS) diagnostic schedule (GMS B3) at both baseline and follow-up interviews. Baseline measures included demographic status, years of education, rural/urban residence, accommodation, past and current occupation, monthly income, marital status, stressful life events, social support deficits, number of physical illnesses, severity of pain, physical activity, disability, depressive symptoms, anxiety, insomnia, cognitive function, alcohol consumption, and smoking.
Baseline SI prevalence, follow-up incidence (SI rate at follow-up of 805 elderly subjects who did not have SI at baseline), and persistence (SI rate at follow-up of 104 elderly subjects who had SI at baseline) were 11.5%, 9.6%, and 36.5%, respectively. Baseline SI was independently associated with no current employment, lower monthly income, stressful life events, more severe pain, presence of disability, depressive symptoms, and smoking. Incident SI was independently predicted by baseline unmarried status, social support deficit, severe pain, presence of depressive symptoms, and smoking. Persistent SI was independently predicted by baseline stressful life events and depressive symptoms.
Depressive symptoms were independently associated with prevalent, incident, and persistent SI, but other predictors varied according to incidence and persistence outcomes.
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.
We report the realization of the p-type conductivity and the enhancement of the photoluminescence (PL) intensity in undoped ZnO films treated with high-energy (1 MeV) electron-beam irradiation (HEEBI), suggesting that the HEEBI process is compatible with a low-temperature requirement for the fabrication of transparent thin film transistors with good efficiency on a plastic substrate. The p-type conductivity of the films was revealed by the Hall, x-ray photoelectron spectroscopy, and PL measurements after being electron-irradiated in air at room temperature. The major acceptor-like defects were determined to be oxygen interstitial and zinc vacancy. A model was proposed in terms of O as well as Zn diffusion to explain the observed results. It was also observed that HEEBI treatment has little influence on the optical transmittance of ZnO films, whereas HEEBI treatment shifts the optical band gap toward the lower energy region from 3.29 to 3.28 eV.
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.
We present the formation of SnO2-In2O3 hetero nanostructures. Kinetically, SnO2 nanowires form prior to the heterostructure. In2O3shell was regularly distributed on the SnO2 nanowire surface, and form sheath subsequently. We theoretically explained the morphological evolution of an anisotropic heterostructure such as core-sheath structure.
The BZN pyrochlore thin films were prepared on platinized Si substrates using a reactive RF magnetron sputtering. The structures, surface morphologies, dielectric properties and voltage tunable properties of films with deposition parameters were investigated. The BZN thin films have a cubic pyrochlore phase and secondary phases of zinc niobate, bismuth niobate when crystallized at 600° 800°. The dielectric constant and tunability of thin films are O2/Ar ratio and post-annealing temperature dependent. The BZN thin films sputtered in 15% O2 and annealed at 700° had a dielectric constant of 153, tan δof~0.003 and maximum tunability of 14% at 1,000kV/cm.
Tin oxide has been proposed as a promising alternative anode material for microbatteries. It has been reported that its theoretical volumetric capacity is four times larger than that of carbon-based materials, while its gravimetric capacity is twice as large. In this experiment, optimal Si and Bi doped SnO2 films were prepared with e-beam evaporation to improve both the cycle performance and the reversible capacity. The films with addition of Si only exhibited reductions in aggregation of tin particles and formation of micro-cracks. However, there still remained cracks, which induce capacity loss during cycling. To improve capacity retention, Bi was added with Si to SnO2 films, which exhibited the highest reversible capacity of 200µAh/cm2-µm at 200th cycle. The films doped with Bi and Si were found to be ill-defined and featureless without noticeable particle aggregation and cracks. However, the films that underwent cycling tests showed again aggregated tin particles and formation of cracks, which would induce cell failure during cycling. We believe that some types of Li-Bi phases as mixed-conductor matrices have improved the cycle life.
A direct synthesis of carbon nanotubes (CNTs) on substrates by chemical vapor deposition (CVD) is one of highly probable routes to reach their application to field emission displays. Several stringent requirements are prerequisite for this purpose, including low temperature growth below 600°C to engage glass substrates and large area deposition for practical use. This study carried out synthesis of CNTs by thermal CVD on glass substrates at temperatures as low as 500~550°C. CNTs were grown by thermal decomposition of CO and H2 gases at an atmospheric pressure for different thickness of Invar (an Fe-Ni-Co alloy ) catalytic layers. The growth of CNTs was strongly correlated with preparation of catalytic layers. The diameters and heights of as-grown CNTs increased as the catalytic layers became thicker from 2nm to 30nm. Measurements of the field emission properties of CNTs showed that the threshold electric fields were lowered with increasing thickness of catalytic layers. A uniform electron emission was observed over a large area of 150 × 150mm2, with high emission currents and high brightness.
The effect of a post plasma treatment on the dielectric properties and reliability of fluorine doped silicon oxide (SiOF) films deposited by electron cyclotron resonance chemical vapor deposition (ECRCVD) was studied. Also, the thermal stability of an electrodeposited Cu / sputtered Ta interconnect system with SiOF intermetal dielectrics was examined by annealing in a vacuum furnace. The stability of the dielectric constant of SiOF films was improved by O2 post plasma treatment. Surface modification by the plasma treatment was effective in prevention of water absorption. The Cu/Ta/SiOF/Si system was thermally stable at least up to 500°C for 3h. For the Cu/Ta/SiOF/Si multilayer structure, the plasma treatment seemed to play a big role in suppressing the interdiffusion between SiOF and metal interconnects. By C-V measurement, the electrical stability of the Cu/Ta/SiOF/Si multilayer structure was found to be stable up to 500°C for 2 h.
This study describes the use of fluorinated silicon nitride film as a bottom antireflective layer (BARL) material suitable for line-patterning in quarter-micron KrF excimer laser lithography. For the structures of photoresist/BARL (300Å)/c-Si and photoresist/BARL (300 Å )/W-Si at a wavelength of 248nm, 0% reflectance could be achieved when the refractive index (n) and extinction coefficient (k) values of the film are 2.11 and 0.68 or 2.05 and 0.59, respectively. The fluorinated silicon nitride thin films on p-type (100) Si substrates obtained by inductively coupled plasma enhanced CVD have been evaluated with the variations of NF3 flow rates under the two conditions of SiH4:N2=2:15 and 3:20 (seem). The films optical constants and reflectance were investigated by spectroscopic ellipsometry combined with a reflectance simulation program. The film n and k values at 248nm vary in the ranges of 1.67~2.35 and 0.01~0.69, respectively, depending on gas flow ratio of SiH4:N2:NF3. Low reflectance of below 5% can be obtained from reflectance simulation for two deposition conditions with a BARL thickness of 300Å. In addition, the reflectance could be reduced to almost 0% by controlling film thickness. Finally, the antireflective layer performance was investigated using KrF excimer laser lithography.
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