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Several factors associated with referral time to hospice and/or palliative care services have been identified, but there is no literature on the association between these services and the emotional status of the family caregivers (FCs). This article is intended to address that issue.
A semistructured interview was employed to collect data for a retrospective cohort study. The primary FCs of terminally ill cancer patients were interviewed at the time of the patient's referral to the palliative care unit. Interview data were combined with patients' medical record data for our analysis. The emotional status of the FCs was categorized into one of three groups according to their responses to the anticipated death of their family member: acceptance, anxious/depressed, and denial/angry. A Cox proportional hazard model was used to examine and identify the factors related to the length of stay (LOS) in the palliative care unit.
A total of 198 patient–FC pairs were identified. The median LOS was 18 days. A multivariate analysis with adjustment for potential variables revealed significant differences in LOS according to cancer type and time since cancer diagnosis. The denial/angry FC category was independently associated with a shorter LOS (vs. acceptance, adjusted hazard ratio (aHR) 2.11; 95% confidence interval (CI), 1.11–4.03).
Significance of Results:
We found that terminally ill cancer patients who were referred late had FCs who were in denial or were angry about the anticipated death of their loved one. The emotional status of FCs should be considered when patients with terminal cancer are referred to palliative care.
We aimed to evaluate the reproducibility and validity of the newly developed FFQ for the Korean National Health and Nutrition Examination Survey (KNHANES) and to estimate the measure’s calibration factors.
The 109-item FFQ was administered twice, approximately 9 months apart. We also collected four seasonal 3 d dietary records (DR) as a reference method. Correlation coefficients and joint classification were computed to compare intakes of energy, thirteen nutrients and eleven food groups between the two FFQ to evaluate reproducibility. For validity, de-attenuated and energy-adjusted correlation, joint classification and Bland–Altman statistics were calculated for energy and nutrients between the first FFQ and the DR. To calibrate the FFQ, we performed a linear regression analysis in which the DR were the dependent variables and FFQ, age and sex were the independent variables.
Seoul metropolitan area, Republic of Korea.
A total of 126 adults aged 20–65 years.
The average correlation coefficients measuring reproducibility were 0·54 for nutrients and 0·57 for food groups. The mean correlation coefficient measuring validity was 0·40 for all nutrients between the first FFQ and the DR. On average, 75 % of the participants were classified into the same or adjacent quartiles, while 5 % of the participants were grossly misclassified. The mean energy and nutrient intakes estimated by the calibrated FFQ were similar to the means estimated by the DR.
The newly developed FFQ for assessing dietary intake in the KNHANES has acceptable reproducibility and modest validity compared with a 12 d DR collected over a 9-month period.
Sources of variation in nutrient intake have been examined for Western diets, but little is known about the sources of variation and their differences by age and sex among Koreans. We examined sources of variation in nutrient intake and calculated the number of days needed to estimate usual intake using 12 d of dietary records (DR). To this end, four 3 d DR including two weekdays and one weekend day were collected throughout four seasons of 1 year from 178 male and 236 female adults aged 20–65 years residing in Seoul, Korea. The sources of variation were estimated using the random-effects model, and the variation ratio (within-individual:between-individual) was calculated to determine a desirable number of days. Variations attributable to the day of the week, recording sequence and seasonality were generally small, although the degree of variation differed by sex and age (20–45 years and 46–65 years). The correlation coefficient between the true intake and the observed intake (r) increased with additional DR days, reaching 0·7 at 3–4 d and 0·8 at 6–7 d. However, the degree of increase became attenuated with additional days: r increased by 13·0–26·9 % from 2 to 4 d, by 6·5–16·4 % from 4 to 7 d and by 4·0–11·6 % from 7 to 12 d for energy and fifteen nutrients. In conclusion, the present study suggests that the day of the week, recording sequence and seasonality minimally contribute to the variation in nutrient intake. To measure Korean usual dietary intake using open-ended dietary instruments, 3–4 d may be needed to achieve modest precision (r>0·7) and 6–7 d for high precision (r>0·8).
We present experimental evidence of enhancement of thermoelectric properties in tellurium (Te) nanoparticle-embedded bismuth antimony telluride (BiSbTe) alloys. Bi0.5Sb1.5Te3 films with a high density of Te particles of 10–20 nm size were prepared by growth of alternating multilayers of ultrathin Te and Bi0.5Sb1.5Te3. As the amount of Te nanoinclusions increased up to ∼15%, the Seebeck coefficient and thermoelectric power factor were increased. Based on the concept of band bending at heterointerfaces as a carrier energy filter, the energy relaxation calculation was made to confirm that the Te nanoinclusions result in a carrier energy filtering effect in p-type bismuth antimony telluride. In addition, thermal conductivities were reduced in the Te-embedded samples, permitting possible further enhancement of the thermoelectric figure of merit. The advantages of Te nanoinclusions in p-type Bi0.5Sb1.5Te3alloys on thermoelectric performance are experimentally realized by both electron- and phonon scattering.
Plant genetic resources (PGR) include cultivars, landraces, wild species closely related to cultivated varieties, breeder's elite lines and mutants. The loss of genetic diversity caused by the practice of agriculture and the availability of genetic information has resulted in a great effort dedicated to the collection of PGR. Prior to the advent of molecular profiling, accessions in germplasm collections were examined based on morphology. The development of molecular techniques now allows a more accurate analysis of large collections. Next-generation sequencing (NGS) with de novo assembly and resequencing has already provided a substantial amount of information, which warrants the coordination of existing databases and their integration into genebanks. Thus, the integration and coordination of genomic data into genebanks is very important and requires an international effort. From the determination of phenotypic traits to the application of NGS to whole genomes, every aspect of genomics will have a great impact not only on PGR conservation, but also on plant breeding programmes.
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 used a database approach in developing a dish-based, semi-quantitative FFQ for Korean diet and cancer research. Cancer-related dietary factors (CRDF) recognised in the scientific community and dietary intake data from the 2001 Korean National Health and Nutrition Examination Survey and the 2002 Korean National Nutrition Survey by Season were used. The list of dishes (n 993) was those reported to be consumed by individuals over 30 years of age during all four seasons. The resulting 112-dish list was selected using contribution analyses and variability analyses to detect between-person variation for CRDF and non-CRDF nutrients. Variations of each dish were grouped into one dish for the final list of 112 dishes, which were then linked to the nutrient database. The final 112 dish items consisted of nine Korean staple dishes, including rice and noodles, twenty-five soups and stews, fifty-four side dishes, nine beverages, nine fruit dishes and six alcoholic beverages. The percentage coverages of energy, protein, fat, carbohydrate and alcohol intake in the selected 112 dishes were 82·4, 76·4, 68·9, 86·0 and 99·8 %, respectively. Dietary exposure to cancer-related Korean dietary factors can be assessed by this new dish-based, semi-quantitative FFQ. This new instrument can calculate the intake of CRDF along with non-CRDF nutrient intake for cancer research.
To investigate the annual rate of tuberculosis (TB) infection among newly employed nurses using both tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT-G; Cellestis Limited) assay.
A prospective cohort study involving newly employed nurses.
A tertiary care university hospital in South Korea.
All participants (n = 196) were tested with the TST and QFT-G assay at baseline. After 1 year, the TST and QFT-G assay were reperformed for subjects who had negative TST results at baseline and for all subjects, respectively.
The baseline TST and QFT-G assays were positive for 101 subjects (51.5%) and 28 subjects (14.3%), respectively; 22 subjects (11.2%) had positive results of both tests. Although the overall between-test agreement was 54.9% (κ = 0.151 [95% confidence interval, 0.047–0.245]), agreement improved to 78.5% (κ = 0.462 [95% confidence interval, 0.007–0.917]) for subjects who had not received bacille Calmette-Guérin vaccination. After 1 year, the TST yielded positive results for 16 (21.3%) of 75 nurses with negative baseline results, and the QFT-G assay yielded positive results for 21 (14.4%) of 146 subjects with negative baseline Results. Collectively, 5 subjects (3.0%) experienced conversion to positive results with both tests, and 32 subjects (18.9%) experienced conversion to positive results with one of the tests. Neither the employing hospital department nor exposure to patients with TB affected test conversion status.
The poor overall agreement between TST and QFT-G results may have been caused by the confounding effect of bacille Calmette-Guérin vaccination. The annual risk of TB infection among newly employed nurses was at least 3% on the basis of results of both the TST and QFT-G test. Stricter preventive strategies against TB spread should be implemented in our hospital.
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.
A nonvolatile memory device with the multi-layered SiC nanocrystals embedded in the SiO2 dielectrics for long-term data storage was fabricated and its electrical properties were evaluated. The SiC nanocrystals were formed by using post thermal annealing process. The transmission electron microscope analysis showed the multi-layered SiC nanocrystals between the tunnel and the control oxide layers. The average size and density of the SiC nanocrystals were approximately 5 nm and 2×1012 cm-2, respectively. The memory window of nonvolatile memory devices with the multi-layered of SiC nanocrystals was about 2.7 V during the operations at ±10 V for 700 ms, and then it was maintained around at 1.1 V after 105 sec.
Silicon dioxide (SiO2) films were deposited on crystalline silicon substrate by inductively coupled plasma chemical vapor deposition (ICP-CVD). In this paper, various process parameter-gas flow rate, ICP RF power, Process pressure were discussed for the investigation of refractive index. And some properties of the SiO2 film are investigated. Since there was no external substrate heating during the deposition, the SiO2 film showed poor electrical characteristics, such as shifted flat-band voltage and high effective charge density. We have proposed He plasma pre-treatment in order to reduce the interface fixed charge and some post-treatment. Our experimental results shows that He plasma pre-treatment supply thermal energy for decomposition of reactant gas and to remove effective charges. Hydrogen post-treatment also enhances electrical characteristics. We measured the effect of the plasma treatment using FT-IR spectrum and C-V characteristics.
The mechanical properties of NiAl/Ni micro-laminated composites with highly gradient microstructure have been investigated. Two types of composites with different gradient microstructures were prepared by reaction synthesis. Intermetallics of type I and type II composites mainly consisted of Al-rich Ni0.45Al0.55 with variable thickness and Ni-rich Ni0.58Al0.42 with similar thickness, respectively. As intermetallic volume fraction increased, yield strength of type II followed the rule-of-mixture well, while that of type I deviated due to the composition variation of intermetallic phases. Fracture toughness of type II was higher than that of type I, and all showed KR curves with upward curvature by large-scale bridging. Even though the relative strength of constituent phases in intermetallic/metal laminates was not constant due to the gradient microstructure, the fracture mode transition showed similar behavior to that of metal/ceramic laminates.
Highly (100) oriented Pb(Zr,Ti)O3 [PZT] films were fabricated using lanthanum nitrate/nickel acetate double layers as a buffer layer, regardless of the other deposition conditions, such as the pyrolysis temperature, pyrolysis time, annealing temperature, and heating rate. The buffer layer was also acted as a very effective barrier against Pb-Si interdiffusion, thus allowing for the direct deposition of PZT films on Si, SiO2/Si, and glass substrates. The strong orientation was attributed to the formation of a crystalline intermediate phase between the PZT and lanthanum nitrate during annealing. The lanthanum nitrate/nickel acetate double layers became a lanthanum nickel oxide (LaNiO3), which shows good electrical conductivity, after an annealing process at 650°C. The nature and the role of lanthanum nitrate buffer as a layer for the growth of highly (100) oriented PZT films have been studied. The dielectric, ferroelectric, piezoelectric and electrooptic properties of the highly (100) oriented PZT films with a lanthanum nitrate/nickel acetate buffer layer were measured and compared with the values measured from the (111) and (100) oriented PZT films deposited without buffer layer.
Micro-tensile properties of hard and soft thin films, TiN and Au, were evaluated by directly measuring tensile strain in film tension using the micro-ESPI(electronic Speckle Pattern Interferometry) technique. Micro-tensile stress-strain curves for these films were obtained and the properties were determined. TiN thin film 1 μm thick and Au films with two different thicknesses (t=0.5 μm and 1 μm) were deposited onto the silicon wafers, respectively, and micro-tensile specimens wide 50, 100 and 200 μm were fabricated using micromachining. In-situ measurement of the micro-tensile strain during tensile loading was carried out using the subsequent strain measurement algorithm and the ESPI system developed in this study. The micro-tensile curves showed that TiN thin film was a linear-elastic material showing no plastic deformation and Au thin film was an elastic-plastic material showing significant plastic flow. Effect of the specimen dimensions on mechanical properties was examined. It was revealed that tensile strengths for both films were slightly increased with increasing specimen width. Furthermore, variations of yielding strengths for the thin film Au with change of the dimension were investigated.
To compare the epidemiology and genetic relatedness of Candida tropicalis isolates causing bloodstream infection (BSI) in two hospitals.
Two tertiary-care hospitals in Korea.
A retrospective molecular epidemiologic analysis using pulsed-field gel electrophoresis (PFGE) was performed with 49 C. tropicalis isolates from sporadic cases of BSI. The isolates were collected from 27 patients at Chonnam National University Hospital (CUH) during a 6-year period and 22 patients at Asan Medical Center (AMC) during a 2-year period.
Based on the PFGE patterns, the average similarity value (SAB) for the 27 isolates from CUH was 0.84 ± 0.08, which was significantly higher than that for the 22 isolates from AMC (0.78 ± 0.06; P < .001). Of the 49 strains from patients at the 2 hospitals, 9 isolates were placed into 3 subtypes with SAB values of 1.0, which indicated that they were identical. All 9 of these strains were isolated from CUH patients, and each type strain was isolated sporadically during a period ranging from 4 months to 3 years. On comparison of the clinical characteristics of the patients of the 2 hospitals, the CUH strains were isolated more frequently from non-neutropenic patients and patients with central venous catheter–related fungemia; cases from CUH had a better outcome than those from AMC (P < .05).
These data show that the clinical and epidemiologic characteristics of C. tropicalis fungemia may differ markedly among hospitals and that some cases of C. tropicalis fungemia may be caused by endemic strains within a hospital.
Large area, flat panel detectors are being investigated for digital radiogrpahy and fluoroscopy. Theses detectors employ an x-ray conversion layer of photoconductor to detect x-rays. The amorphous selenium layer that is currently being studied for its use as an x-ray photoconductor is not pure a-Se but rather a-Se doped with 0.2-0.5% As and 10-30 ppm Cl, also known as stabilized a-Se. The suitability of the stabilized a-Se is largely determined by its charge on generating, transporting and trapping properties.
In this paper, a conventional time-of-flight measurement was carried out to analyze the transport properties of charge carriers. A laser beam with pulse duration of 5 ns and wavelength of 350 nm was illuminated on the surface of the stabilized a-Se with thickness of 400 μm. The photo response signals of the hole and electron were measured at the applied electric field of 10 V/μm as a function of time. The measured transit times of the hole and electron were about 229.17μs and about 8.73μs at 10 V/μm, respectively. The measured mobility indicated a slight dependence with respect to the applied electric field with a range of 4-10 V/μm. The experimental results showed that the measured mobility of the hole and electron was 0.04584 cm2V-1s-1 and 0.00174 cm2V-1s-1 at the electric field of 10 V/μm.
Combinatorial chemistry was applied to the optimization of red phosphors used for plasma display panels. Quaternary and ternary combinatorial libraries were developed for (Y, Gd, Lu, Sc)BO3 and (Y, Gd)(BO3 PO4) systems. Our combinatorial chemistry system consists of solution-based combinatorial synthesis and characterization, enabling the swift scanning of luminance and of Commission Internationale de l'Eclairage (CIE) chromaticity under vacuum ultraviolet light excitation. As a consequence of the combinatorial approach, several new candidates were found to show higher luminance than the commercially available red phosphor for plasma display panels.
The Fossil Brook Member of the upper Chamberlain's Brook Formation is a thin (up to 14 m) but distinctive, unconformity-bound depositional sequence recognizable from Rhode Island to eastern Newfoundland in Avalonian North America. Its diverse trilobite fauna was first described more than century ago from the limestone-rich facies of the member in southern New Brunswick. However, the systematics, stratigraphic context, and biostratigraphic significance of these trilobites have remained poorly known. A revision of the conocoryphid and paradoxidid trilobites has been completed, and the taxa set into their stratigraphic context within the middle Middle Cambrian. The faunas of the Fossil Brook are assigned to the Eccaparadoxides eteminicus Zone of Avalon. Although biogeographic barriers between Avalon and Gondwana remained strong in the Middle Cambrian and few shared trilobite species are present, a generalized correlation of the E. eteminicus Zone into Gondwana is with the Badulesia tenera Zone of the Toushamian Stage in Morocco and the Badulesia Zone of the Caesaraugustian Stage in Spain.