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Predictors of compliance with aspirin in children following cardiac catheterisation have not been identified. The aim of this study is to identify the caregivers’ knowledge, compliance with aspirin medication, and predictors of compliance with aspirin in children with Congenital Heart Disease (CHD) post-percutaneous transcatheter occlusion.
A cross-sectional explorative design was adopted using a self-administered questionnaire and conducted between May 2017 and May 2018. Recruited were 220 caregivers of children with CHD post-percutaneous transcatheter occlusion. Questionnaires included child and caregivers’ characteristics, a self-designed and tested knowledge about aspirin scale (scoring scale 0–2), and the 8-item Morisky Medication Adherence Scale (scoring scale 0–8). Data were analysed using multivariate binary logistic regression analysis to identify predictors of compliance with aspirin.
Of the 220 eligible children and caregivers, 210 (95.5%) responded and 209 surveys were included in the analysis. The mean score of knowledge was 7.25 (standard deviation 2.27). The mean score of compliance was 5.65 (standard deviation 1.36). Child’s age, length of aspirin use, health insurance policies, relationship to child, monthly income, and knowledge about aspirin of caregivers were independent predictors of compliance with aspirin (p < 0.05).
Caregivers of children with CHD had an adequate level of knowledge about aspirin. Compliance to aspirin medication reported by caregivers was low. Predictors of medium to high compliance with aspirin were related to the child’s age and socio-economic reasons. Further studies are needed to identify effective strategies to improve knowledge, compliance with medication, and long-term outcomes of children with CHD.
We report our experience with an emergency room (ER) shutdown related to an accidental exposure to a patient with coronavirus disease 2019 (COVID-19) who had not been isolated.
A 635-bed, tertiary-care hospital in Daegu, South Korea.
To prevent nosocomial transmission of the disease, we subsequently isolated patients with suspected symptoms, relevant radiographic findings, or epidemiology. Severe acute respiratory coronavirus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction assays (RT-PCR) were performed for most patients requiring hospitalization. A universal mask policy and comprehensive use of personal protective equipment (PPE) were implemented. We analyzed effects of these interventions.
From the pre-shutdown period (February 10–25, 2020) to the post-shutdown period (February 28 to March 16, 2020), the mean hourly turnaround time decreased from 23:31 ±6:43 hours to 9:27 ±3:41 hours (P < .001). As a result, the proportion of the patients tested increased from 5.8% (N=1,037) to 64.6% (N=690) (P < .001) and the average number of tests per day increased from 3.8±4.3 to 24.7±5.0 (P < .001). All 23 patients with COVID-19 in the post-shutdown period were isolated in the ER without any problematic accidental exposure or nosocomial transmission. After the shutdown, several metrics increased. The median duration of stay in the ER among hospitalized patients increased from 4:30 hours (interquartile range [IQR], 2:17–9:48) to 14:33 hours (IQR, 6:55–24:50) (P < .001). Rates of intensive care unit admissions increased from 1.4% to 2.9% (P = .023), and mortality increased from 0.9% to 3.0% (P = .001).
Problematic accidental exposure and nosocomial transmission of COVID-19 can be successfully prevented through active isolation and surveillance policies and comprehensive PPE use despite longer ER stays and the presence of more severely ill patients during a severe COVID-19 outbreak.
To identify the association of the glucokinase gene (GCK) rs4607517 polymorphism with gestational diabetes mellitus (GDM) and determine whether sweets consumption could interact with the polymorphism on GDM in Chinese women.
We conducted a case–control study at a hospital including 1015 participants (562 GDM cases and 453 controls). We collected the data of pre-pregnancy BMI, sweets consumption and performed genotyping of the GCK rs4607517 polymorphism. Logistic regression was performed to test the association between the rs4607517 polymorphism and GDM, and the stratified analyses by sweets consumption were conducted, using an additive genetic model.
A case–control study of women at a hospital in Beijing, China.
One thousand and fifteen Chinese women.
The GCK rs4607517 A allele was significantly associated with GDM (OR 1·35, 95 % CI 1·03, 1·77; P = 0·028). Furthermore, stratified analyses showed that the A allele increased the risk of GDM only in women who had a habitual consumption of sweet foods (sweets consumption ≥ once per week) (OR 1·61, 95 % CI 1·17, 2·21; P = 0·003). Significant interaction on GDM was found between the rs4607517 A allele and sweets consumption (P = 0·004).
This study for the first time reported the interaction between the GCK rs4607517 polymorphism and sweets consumption on GDM. The results provided novel evidence for risk assessment and personalised prevention of GDM.
Early consciousness recovery after cardiac arrest (CA) is one of the most explicit and self-evident prognostic factors for clinical outcomes. We aimed to evaluate the prognostic value of electroencephalography (EEG) phenotypes according to the American Clinical Neurophysiology Society’s Critical Care EEG classification for predicting early recovery after CA.
Consecutive patients admitted to the ICU after CA were enrolled. We analyzed Glasgow Coma Scale (GCS) score within 10 days after CA and evaluated mortality within 28 days according to EEG pattern subtype.
Among the total of 71 patients, 9 had periodic discharges (PDs) EEG pattern, 4 had rhythmic delta activity (RDA), 8 had spike-and-wave (SW), 22 had low voltage, 5 had burst suppression, and 23 had other EEG patterns. Initial GCS scores, GCS scores 3 days after CA (or 3 days after targeted temperature management [TTM]), and 10 days after CA (or 10 days after TTM) were significantly different among EEG subtypes (p < 0.001, respectively) (Table 2). GCS scores were significantly higher in RDA and the other EEG group compared to the PDs, SW, low voltage, and burst suppression groups (p < 0.001). Significant group × time interactions were observed for the follow-up period between EEG phenotypes (p < 0.001) demonstrating the most increase in the other EEG pattern group.
Consciousness states were significantly worse in the PDs, SW, burst suppression, and low-voltage groups compared to the RDA and the other EEG pattern within 10 days after CA. The degree of consciousness recovery differed significantly by EEG pattern subtype within 10 days.
We aimed to evaluate the relationship of plasma Mg with the risk of new-onset hyperuricaemia and examine any possible effect modifiers in hypertensive patients. This is a post hoc analysis of the Uric acid (UA) Sub-study of the China Stroke Primary Prevention Trial (CSPPT). A total of 1685 participants were included in the present study. The main outcome was new-onset hyperuricaemia defined as a UA concentration ≥417 μmol/l in men or ≥357 μmol/l in women. The secondary outcome was a change in UA concentration defined as UA at the exit visit minus that at baseline. During a median follow-up duration of 4·3 years, new-onset hyperuricaemia occurred in 290 (17·2 %) participants. There was a significantly inverse relation of plasma Mg with the risk of new-onset hyperuricaemia (per sd increment; OR 0·85; 95 % CI 0·74, 0·99) and change in UA levels (per sd increment; β −3·96 μmol/l; 95 % CI −7·14, −0·79). Consistently, when plasma Mg was analysed as tertiles, a significantly lower risk of new-onset hyperuricaemia (OR 0·67; 95 % CI 0·48, 0·95) and less increase in UA levels (β −8·35 μmol/l; 95 % CI −16·12, −0·58) were found among participants in tertile 3 (≥885·5 μmol/l) compared with those in tertile 1 (<818·9 μmol/l). Similar trends were found in males and females. Higher plasma Mg levels were associated with a decreased risk of new-onset hyperuricaemia in hypertensive adults.
We report direct numerical simulation results that clearly elucidate the mechanism that leads to curvature dependence of drag enhancement (DE) in viscoelastic turbulent Taylor–Couette flow. Change in the angular momentum transport and its inherent link to transitions in vortical flow structures have been explored to depict the influence of the curvature of the flow geometry on DE. Specifically, it has been demonstrated that a transition in vortical structures with increasing radius ratio leads to weakening and elimination of the small-scale Görtler vortices and development and better organization (occupying the entire gap) of large-scale Taylor vortices as also evinced by the patterns of angular momentum current. The commensurate change in DE and its underlying mechanism are examined by contributions of convective flux and polymeric stress to the angular momentum current. The present finding paves the way for capturing highly localized elastic turbulence structures in direct numerical simulation by increasing geometry curvature in traditional turbulent curvilinear flows.
We aimed to investigate the association between plasma retinol and incident cancer among Chinese hypertensive adults. We conducted a nested case–control study, including 231 patients with incident cancer and 231 matched controls during a median 4·5-year follow-up of the China Stroke Primary Prevention Trial. There was a significant, inverse association between retinol levels and digestive system cancer (per 10 μg/dl increases: OR 0·79; 95 % CI 0·69, 0·91). When compared with participants in the first quartile of retinol (< 52·3 μg/dl), a significantly lower cancer risk was found in participants in quartile 2–4 ( ≥ 52·3 μg/dl: OR 0·31; 95 % CI 0·13, 0·71). However, there was a U-shaped association between retinol levels and non-digestive system cancers where the risk of cancers decreased (although not significantly) with each increment of plasma retinol (per 10 μg/dl increases: OR 0·89; 95 % CI 0·60, 1·31) in participants with retinol < 68·2 μg/dl, and then increased significantly with retinol (per 10 μg/dl increase: OR 1·65; 95 % CI 1·12, 2·44) in participants with retinol ≥ 68·2 μg/dl. In conclusion, there was a significant inverse dose–response association between plasma retinol and the risk of digestive system cancers. However, a U-shaped association was observed between plasma retinol and the risk of non-digestive cancers (with a turning point approximately 68·2 μg/dl).
AlMgB14–TiB2 ceramic was successfully brazed to TC4 alloy with inactive AgCu filler alloy. X-ray diffractometer, SEM, and energy-dispersive spectrometer were used to study interfacial microstructure and shear strength of the joints under different brazing temperatures. The results indicated that the typical microstructure of the TC4/AlMgB14–TiB2 joint was TC4/Ti(s.s) + Ti2Cu/Ti2Cu/TiCu/TiCu2Al/Ag(s.s) + Cu(s.s)/TiB whiskers/TiB2 reaction layer/AMBT. By increasing the brazing temperature, the thickness of the TC4 diffusion layer was improved, whereas that of the brazing seam decreased remarkably. When the brazing temperature was increased to 880 °C, the brazing seam was composed of Ti–Cu intermetallic Ag(s.s) with a few Cu(s.s), TiCu2Al distributed. Meanwhile, the formation of a continuous TiB2 reaction layer at the interface of the AMBT and brazing filler facilitated the improvement of joint shear strength. The joint with the maximum shear strength of 46.7 MPa was obtained while brazing at 880 °C for 10 min.
In Democratic People's Republic of Korea, only Plasmodium vivax malaria is prevalent, which is divided into two forms – long incubation form and short form. Among malaria cases reported in a year, long form accounts for 69% and short form 31%. Incubation period of short form ranges from 10 to 29 days (average 17 days) and long from 5·5 to 16 months (average 8–13 months). The most relapses (90%) were reported from May to September – malaria transmission season in the country. Result from preliminary mass chemoprevention in small size of population before transmission season to find appropriate method showed high protective efficacy in two regimens – one regimen given primaquine 0·25 mg base kg−1 day−1 for 14 days (95%) and another 0·5 mg base kg−1 day−1 for 7 days (94%). During the mass chemoprevention with primaquine, some adverse effects were reported but transient. We consider that mass chemoprevention with primaquine before transmission season is of great significance in disturbing the vivax malaria transmission, in which long incubation form is predominant in countries prevailing seasonal malaria.
The lichen family Ophioparmaceae contains three genera: Boreoplaca, Hypocenomyce and Ophioparma. The genus Hypocenomyce is reported here for the first time for China, being represented by the species Hypocenomyce scalaris which is distributed in south-western China. For the genus Ophioparma, one new species is described in this paper, namely Ophioparma pruinosa Li S. Wang & Y. Y. Zhang sp. nov., which is characterized by a pruinose thallus and the presence of usnic acid. Ophioparma araucariae is also reported as new for the Chinese lichen biota. Previous reports of O. lapponica in China are recognized as misidentifications of O. ventosa. Descriptions, keys and phylograms are provided for these species.
We aimed to assess shared genetic correlations of depressive and anxiety symptoms with concurrent and future estimated cardiovascular risk (CVR) score in Korean twins and family members. For the relationship with Adult Treatment Panel III CVR estimate in subjects aged 30–74 years (n = 1,059, baseline and follow-up after 3.2 ± 1.2 years), Center for Epidemiological Studies Depression Scale (CES-D) and state and trait anxiety inventory (SAI and TAI) were measured at baseline. A mixed linear model for CVR scores at baseline and follow-up was applied to include depressive and anxiety symptoms, twin and family effects, income, education, alcohol use, exercise, body mass index, and baseline CVR score for follow-up analysis. Higher CES-D scores were associated with higher CVR score at baseline in men, while higher TAI score was associated with higher CVR score at follow-up in women. Heritabilities were 0.245~0.326 for CVR score, 0.320 for CES-D score, 0.367 for TAI score, and 0.482 for SAI score. There were significant common genetic correlations in the relationships of CES-D, TAI, and SAI scores with CVR scores at baseline and follow-up (after adjusting for baseline CV risk score). Shared common environmental correlations were observed in the relationships of CES-D and SAI scores with CVR score at baseline; and SAI score with CVR score at follow-up. In the within-monozygotic twin analysis, there were no associations between CES-D, TAI, and SAI scores, and CVR score. In conclusion, shared genetic and environmental influences were observed in the relationship between depressive and anxiety symptoms with concurrent and future CVR estimates.
Neuroticism, a ‘Big Five’ personality trait, has been associated with sub-clinical traits of both autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The objective of the current study was to examine whether causal overlap between ASD and ADHD traits can be accounted for by genetic and environmental risk factors that are shared with neuroticism. We performed twin-based structural equation modeling using self-report data from 12 items of the Neo Five-Factor Inventory Neuroticism domain, 11 Social Responsiveness Scale items, and 12 Adult ADHD Self-Report Scale items obtained from 3,170 young adult Australian individual twins (1,081 complete pairs). Univariate analysis for neuroticism, ASD, and ADHD traits suggested that the most parsimonious models were those with additive genetic and unique environmental components, without sex limitation effects. Heritability of neuroticism, ASD, and ADHD traits, as measured by these methods, was moderate (between 40% and 45% for each respective trait). In a trivariate model, we observed moderate phenotypic (between 0.45 and 0.62), genetic (between 0.56 and 0.71), and unique environmental correlations (between 0.37and 0.55) among neuroticism, ASD, and ADHD traits, with the highest value for the shared genetic influence between neuroticism and self-reported ASD traits (rg = 0.71). Together, our results suggest that in young adults, genetic, and unique environmental risk factors indexed by neuroticism overlap with those that are shared by ASD and ADHD.
The shear-band propagation in bulk metallic glasses (BMGs) during deformation plays a key role in determining their macroscopic ductility. In this work, the shear band propagation during plastic deformation was investigated in the Cu46Zr46Al8 BMG and its in situ or ex situ prepared BMG composites. Compared with the brittle BMG, both types of ductile BMG composites show a more stable shear banding behavior as revealed by a larger power-law scaling exponent obtained from statistical analysis of serrations recorded in compressive curves. A higher cut-off elastic energy density (δc) linked with the multiplication of shear bands is observed for the in situ prepared BMG composites. However, the ex situ fabricated BMG composites show an almost equivalent or slightly larger δc since the dominant shear band but not multiple shear bands mainly governs their deformation. Such observations imply that the shear banding stability of BMGs during deformation is enhanced not only by inducing multiple shear bands but also by obstructing the movement of the dominant shear band at its driven path.
Radiocarbon (14C) is a radionuclide generated mainly through neutron-induced reactions in all types of nuclear reactors. Since most of the 14C released into the environment is in the form of gaseous emissions (CO2 and hydrocarbons), terrestrial plants are the primary indicators of increased 14C levels near nuclear power plants (NPPs). In 2013–2014, we collected samples of silver grasses (including common reed) and pine needles within 3 km of four South Korean NPP centers and measured 14C activities using accelerator mass spectrometry (AMS) at Seoul National University. The highest 14C activities were observed, respectively, in Wolsong>Hanul>Kori>Hanbit [220, 143, 127, and 123% modern carbon (pMC)].
An accessory navicular bone (AN) is the most common accessory ossicle in the foot. The presence of an AN bone can trigger various foot problems, such as posterior tibial tendon pathology, flattening of the medial longitudinal arch, and medial foot pain. Despite the clinical influence of presence of an AN in foot disease, the research regarding its inheritance is still insufficient. A total of 135 pairs of monozygotic (MZ) twins, 25 pairs of dizygotic (DZ) twins, and 676 singletons from families were enrolled in order to estimate genetic influences on AN. After confirmation of zygosity and family relationship with a tandem repeat marker kit and questionnaires, the presence and type of the AN was classified through bilateral feet radiographic examination. The heritability of an AN was estimated using quantitative genetic analysis based on a variance decomposition model considering various types of family relationships: father–offspring pair, mother–offspring pair, and pooled DZ twin and sibling pairs. As a result, approximately 40.96% of the participants in this study had an AN in either foot, with type II being the most common type. The heritability for the presence of any type of an AN in any foot was estimated as 0.88 (95% CI [0.82, 0.94]) after adjusting for age and sex. Specifically, type II AN showed the highest heritability of 0.82 (95% CI [0.71–0.93]). The high heritability of an AN found in this large twin and family study suggests that an AN is determined by the substantial influence of genetic factor.
Stable carbon isotope ratios were measured on the alpha-cellulose in tree rings of a pine tree (Pinus densiflora) from Yeongwol, Korea. We developed an annual-resolution δ13C series (1835–1905) by correcting the measured data for changes in δ13C of air to minimize non-climatic influences. To investigate the climatic signal in the δ13C series, we performed correlation analysis between δ13C and the Cheugugi climate data. The Cheugugi precipitation data were first recorded by King Sejong (1397–1450) of the Joseon Dynasty. However, the longest set of precipitation data available is the one collected in Seoul (1776–1907). Although many studies support the reliability of the Cheugugi data, no previous studies have investigated the potential of the δ13C signal in tree rings as paleoclimate proxy using the Cheugugi data. Recent precipitation trends in Yeongwol are quite similar to that of Seoul, and we found significant correlations between the Cheugugi data and the δ13C series. We suggest further studies to replicate these results and confirm whether comparing δ13C variations in tree rings and Cheugugi data is a useful method of investigating the potential of the δ13C signal as a paleoclimate proxy in or near the Korean peninsula.
Palaeoproterozic metasedimentary rocks, also referred to as khondalites, characterized by Al-rich minerals, are extensively exposed in the nucleus of the Yangtze craton, South China block. Samples of garnet–sillimanite gneiss in the khondalite suite were collected from the Kongling complex for Nd isotopic and elemental geochemical study. These rocks are characterized by variable SiO2 contents ranging from 35.71 to 58.07 wt%, and have low CaO (0.45–0.84 wt%) but high Al2O3 (18.56–29.04 wt%), Cr (174–334 ppm) and Ni (42.5–153 ppm) contents. They have high CIW (Chemical Index of Weathering) values (90.4–94.7), indicating intense chemical weathering of the source material. The samples display light rare earth elements (LREE) enrichment with negative Eu anomalies (Eu/Eu*=0.40–0.68), and have flat heavy rare earth elements (HREE) patterns. The high contents of transition elements (e.g. Cr, Ni, Sc, V) and moderately radiogenic Nd isotopic compositions suggest that the paragneisses might be those of first-cycle erosion products of predominantly mafic rocks mixing with small amounts of felsic moderately evolved Archaean crustal source. Geochemical and Nd isotopic compositions reveal that at least some of the protoliths of Kongling khondalite were sourced from local pre-existing mafic igneous rocks in a continental arc tectonic setting. Combined with documented zircon U–Pb geochronological data, we propose that the Palaeoproterozoic high-pressure granulite-facies metamorphism, rapid weathering, erosion and deposition of the khondalites in the interior of the Yangtze craton might be related to a Palaeoproterozoic collisional orogenic event during 2.1–1.9 Ga, consistent with the worldwide contemporary orogeny, implying that the Yangtze craton may have been an important component of the Palaeoprotorozoic Columbia supercontinent.
Family study can provide estimates of overall genetic influences on a particular trait because family relationships provide accurate measures of average genetic sharing. However, evidence of genetic contributions to skin phenotypes is limited, which may preclude genetic studies to identify genetic variants or to understand underlying molecular biology of skin traits. This study aimed to estimate genetic and environmental contributions to selected dermatologic phenotypes, that is, to melanin index, sebum secretion, and skin humidity level in a Korean twin-family cohort. We investigated more than 2,000 individuals from 486 families, including 388 monozygotic twin pairs and 82 dizygotic twin pairs. Variance component method was used to estimate genetic influences in terms of heritability. Heritability of skin melanin index, sebum secretion, and skin humidity (arm and cheek) were estimated to be 0.44 [95% CI 0.38–0.49], 0.21 [95% CI 0.16–0.26], 0.13 [95% CI 0.07–0.18], and 0.11 [95% CI 0.06–0.16] respectively, after adjusting for confounding factors. Our findings suggest that genetics play a major role on skin melanin index, but only mild roles on sebum secretion and humidity. Sebum secretion and skin humidity are controlled predominantly by environmental factors notably on shared environments among family members. We expect that our findings add insight to determinants of common dermatologic traits, and serve as a reference for biologic studies.
Container shipping is one of the most important transport modes in international trade. For a large-scale container shipping network, an optimisation model is proposed to minimise the total shipping cost of container flow. Considering the directional property of the container shipping process, a steering vector search pattern is incorporated in a Max-Min Ant System (MMAS) solving algorithm, and an orthogonal array method is adopted in parameter settings. In numerical experiments, a traditional ant colony algorithm and an MMAS algorithm based on a steering vector search pattern are used respectively to optimise the network of five node scales. The results show that a steering vector search pattern can speed up the computation process and improve the optimisation effect.
We analyzed birth order differences in means and variances of height and body mass index (BMI) in monozygotic (MZ) and dizygotic (DZ) twins from infancy to old age. The data were derived from the international CODATwins database. The total number of height and BMI measures from 0.5 to 79.5 years of age was 397,466. As expected, first-born twins had greater birth weight than second-born twins. With respect to height, first-born twins were slightly taller than second-born twins in childhood. After adjusting the results for birth weight, the birth order differences decreased and were no longer statistically significant. First-born twins had greater BMI than the second-born twins over childhood and adolescence. After adjusting the results for birth weight, birth order was still associated with BMI until 12 years of age. No interaction effect between birth order and zygosity was found. Only limited evidence was found that birth order influenced variances of height or BMI. The results were similar among boys and girls and also in MZ and DZ twins. Overall, the differences in height and BMI between first- and second-born twins were modest even in early childhood, while adjustment for birth weight reduced the birth order differences but did not remove them for BMI.