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Accurate prognostication is important for patients and their families to prepare for the end of life. Objective Prognostic Score (OPS) is an easy-to-use tool that does not require the clinicians’ prediction of survival (CPS), whereas Palliative Prognostic Score (PaP) needs CPS. Thus, inexperienced clinicians may hesitate to use PaP. We aimed to evaluate the accuracy of OPS compared with PaP in inpatients in palliative care units (PCUs) in three East Asian countries.
This study was a secondary analysis of a cross-cultural, multicenter cohort study. We enrolled inpatients with far-advanced cancer in PCUs in Japan, Korea, and Taiwan from 2017 to 2018. We calculated the area under the receiver operating characteristics (AUROC) curve to compare the accuracy of OPS and PaP.
A total of 1,628 inpatients in 33 PCUs in Japan and Korea were analyzed. OPS and PaP were calculated in 71.7% of the Japanese patients and 80.0% of the Korean patients. In Taiwan, PaP was calculated for 81.6% of the patients. The AUROC for 3-week survival was 0.74 for OPS in Japan, 0.68 for OPS in Korea, 0.80 for PaP in Japan, and 0.73 for PaP in Korea. The AUROC for 30-day survival was 0.70 for OPS in Japan, 0.71 for OPS in Korea, 0.79 for PaP in Japan, and 0.74 for PaP in Korea.
Significance of results
Both OPS and PaP showed good performance in Japan and Korea. Compared with PaP, OPS could be more useful for inexperienced physicians who hesitate to estimate CPS.
The explosive outbreak of COVID-19 led to a shortage of medical resources, including isolation rooms in hospitals, healthcare workers (HCWs) and personal protective equipment. Here, we constructed a new model, non-contact community treatment centres to monitor and quarantine asymptomatic and mildly symptomatic COVID-19 patients who recorded their own vital signs using a smartphone application. This new model in Korea is useful to overcome shortages of medical resources and to minimise the risk of infection transmission to HCWs.
The effects of CaTiO3 (CT) and BaZrO3 (BZ) modification upon the crystal structure and electromechanical properties of lead-free Bi0.5Na0.5TiO3–SrTiO3 piezoelectric ceramics were compared within a doping range of 0–4 mol%. The different effects of CT and BZ modification upon the phase transition are clearly observed in the polarization and strain hysteresis loops. The CT-modified specimens maintain strong ferroelectricity without any abnormal enhancement in the electric field-induced strain. However, the addition of as little as 1 mol% BZ induces a transition from a nonergodic relaxor phase to an ergodic relaxor phase, thus resulting in disruption of the ferroelectric order and the generation of a high field-induced strain. The present authors believe that the substitution of large ions (such as Zr4+) into the B-sites, rather than the A-sites, of the Bi0.5Na0.5TiO3-based ceramics plays a significant role in the phase transition behavior.
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.
Although neurocognitive dysfunction and physical performance are known to be impaired in patients with schizophrenia, evidence regarding the relationship between these two domains remains insufficient. Thus, we aimed to investigate the relationship between various physical performance domains and cognitive domains in individuals with schizophrenia, while considering other disorder-related clinical symptoms.
Sixty patients with schizophrenia participated in the study. Cardiorespiratory fitness and functional mobility were evaluated using the step test and supine-to-standing (STS) test, respectively. Executive function and working memory were assessed using the Stroop task and Sternberg working memory (SWM) task, respectively. Clinical symptoms were evaluated using the Brief Psychiatric Rating Scale, Beck Depression Inventory, and State-Trait Anxiety Inventory. Multivariate analyses were performed to adjust for relevant covariates and identify predictive factors associated with neurocognition.
Multiple regression analysis revealed that the step test index was most strongly associated with reaction time in the Stroop task (β = 0.434, p = 0.001) and SWM task (β = 0.331, p = 0.026), while STS test time was most strongly associated with accuracy on the Stoop task (β=−0.418, p = 0.001) and SWM task (β=−0.383, p = 0.007). Total cholesterol levels were positively associated with Stroop task accuracy (β=−0.307, p = 0.018) after controlling for other clinical correlates. However, clinical symptoms were not associated with any variables in Stroop or SWM task.
The present findings demonstrate the relationship between physical performance and neurocognition in patients with schizophrenia. Considering that these factors are modifiable, exercise intervention may help to improve cognitive symptoms in patients with schizophrenia, thereby leading to improvements in function and prognosis.
Single photon sources (SPS) are an important building block for realizing quantum technologies for computing, communication, and sensing. For industrialization, electrically controllable color centers acting as SPS are required. We have demonstrated the creation of electrically controllable silicon vacancies (VSis) in the SiC pn junction diode fabricated by proton beam writing (PBW). PBW was successfully used to introduce electrically controllable VSi without degradation of the diode performance. The dependence of the electroluminescence (EL) and photoluminescence (PL) intensities from VSi on H+ fluence revealed that the emission efficiency of EL is less than that of PL. For EL, the supply of carriers (electrons and/or holes) was restricted due to the resistive region around each VSi introduced by PBW. The results suggest that further improvement in the VSi creation process without defects acting as majority carrier removal centers (highly resistive region) and nonradiative centers by optimization of PBW conditions are key points to realize highly sensitive quantum sensors using VSi.
Spirituality is what gives people meaning and purpose in life, and it has been recognized as a critical factor in patients’ well-being, particularly at the ends of their lives. Studies have demonstrated relationships between spirituality and patient-reported outcomes such as quality of life and mental health. Although a number of studies have suggested that spiritual belief can be associated with mortality, the results are inconsistent. We aimed to determine whether spirituality was related to survival in advanced cancer inpatients in Korea.
For this multicenter study, we recruited adult advanced cancer inpatients who had been admitted to seven palliative care units with estimated survival of <3 months. We measured spirituality at admission using the Korean version of the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-sp), which comprises two subscales: meaning/peace and faith. We calculated a Kaplan-Meier curve for spirituality, dichotomized at the predefined cutoffs and medians for the total scale and each of the two subscales, and performed univariate regression with a Cox proportional hazard model.
We enrolled a total of 204 adults (mean age: 64.5 ± 13.0; 48.5% female) in the study. The most common primary cancer diagnoses were lung (21.6%), colorectal (18.6%), and liver/biliary tract (13.0%). Median survival was 19.5 days (95% confidence interval [CI95%]: 23.5, 30.6). Total FACIT-sp score was not related to survival time (hazard ratio [HR] = 0.981, CI95% = 0.957, 1.007), and neither were the scores for its two subscales, meaning/peace (HR = 0.969, CI95% = 0.932, 1.008) and faith (HR = 0.981, CI95% = 0.938, 1.026).
Significance of results
Spirituality was not related to survival in advanced cancer inpatients in Korea. Plausible mechanisms merit further investigation.
It has not been well established whether dietary folate intake reduces the risk of diabetes development. We aimed to clarify the prospective association between dietary folate intake and type 2 diabetes (T2D) risk among 7333 Korean adults aged 40 years or older who were included in the Multi-Rural Communities Cohort. Dietary folate intake was estimated from all 106 food items listed on a FFQ, not including folate intake from supplements. Two different measurements of dietary folate intake were used: the baseline consumption and the average consumption from baseline until just before the end of follow-up. The association between folate intake and T2D risk was determined through a modified Poisson regression model with a robust error estimator controlling for potential confounders. For 29 745 person years, 319 cases of diabetes were ascertained. In multivariable analyses, dietary folate intake was inversely associated with risk of T2D for women, not for men. For women, the incidence rate ratio of diabetes in the third tertile compared with the first tertile was 0·57 (95 % CI 0·38–0·87, Pfor trend=0·0085) in the baseline consumption model and 0·64 (95 % CI 0·43–0·95, Pfor trend=0·0244) in the average consumption model. These inverse associations was found in both normal fasting blood glucose group and impaired fasting glucose group among women. Among non-users of multinutrients and vitamin supplements, the significant inverse association remained. Thus, higher dietary intake of folate is prospectively associated with lower risk of diabetes for women.
Allicin (AL) regulates the cellular redox, proliferation, viability, and cell cycle of different cells against extracellular-derived stress. This study investigated the effects of allicin treatment on porcine oocyte maturation and developmental competence. Porcine oocytes were cultured in medium supplemented with 0 (control), 0.01, 0.1, 1, 10 or 100 μM AL, respectively, during in vitro maturation (IVM). The rate of polar body emission was higher in the 0.1 AL-treated group (74.5% ± 2.3%) than in the control (68.0% ± 2.6%) (P < 0.1). After parthenogenetic activation, the rates of cleavage and blastocyst formation were significantly higher in the 0.1 AL-treated group than in the control (P < 0.05). The reactive oxygen species level at metaphase II did not significantly differ among all groups. In matured oocytes, the expression of both BAK and CASP3, and BIRC5 was significantly lower and higher, respectively, in the 0.1 AL-treated group than in the control. Similarly, the expression of BMP15 and CCNB1, and the activity of phospho-p44/42 mitogen-activated protein kinase (MAPK), significantly increased. These results indicate that supplementation of oocyte maturation medium with allicin during IVM improves the maturation of oocytes and the subsequent developmental competence of porcine oocytes.
Decreased hemoglobin levels increase the risk of developing dementia among the elderly. However, the underlying mechanisms that link decreased hemoglobin levels to incident dementia still remain unclear, possibly due to the fact that few studies have reported on the relationship between low hemoglobin levels and neuroimaging markers. We, therefore, investigated the relationships between decreased hemoglobin levels, cerebral small-vessel disease (CSVD), and cortical atrophy in cognitively healthy women and men.
Cognitively normal women (n = 1,022) and men (n = 1,018) who underwent medical check-ups and magnetic resonance imaging (MRI) were enrolled at a health promotion center. We measured hemoglobin levels, white matter hyperintensities (WMH) scales, lacunes, and microbleeds. Cortical thickness was automatically measured using surface based methods. Multivariate regression analyses were performed after controlling for possible confounders.
Decreased hemoglobin levels were not associated with the presence of WMH, lacunes, or microbleeds in women and men. Among women, decreased hemoglobin levels were associated with decreased cortical thickness in the frontal (Estimates, 95% confidence interval, −0.007, (−0.013, −0.001)), temporal (−0.010, (−0.018, −0.002)), parietal (−0.009, (−0.015, −0.003)), and occipital regions (−0.011, (−0.019, −0.003)). Among men, however, no associations were observed between hemoglobin levels and cortical thickness.
Our findings suggested that decreased hemoglobin levels affected cortical atrophy, but not increased CSVD, among women, although the association is modest. Given the paucity of modifiable risk factors for age-related cognitive decline, our results have important public health implications.
There is increasing evidence of a relationship between underweight or obesity and dementia risk. Several studies have investigated the relationship between body weight and brain atrophy, a pathological change preceding dementia, but their results are inconsistent. Therefore, we aimed to evaluate the relationship between body mass index (BMI) and cortical atrophy among cognitively normal participants.
We recruited cognitively normal participants (n = 1,111) who underwent medical checkups and detailed neurologic screening, including magnetic resonance imaging (MRI) in the health screening visits between September 2008 and December 2011. The main outcome was cortical thickness measured using MRI. The number of subjects with five BMI groups in men/women was 9/9, 148/258, 185/128, 149/111, and 64/50 in underweight, normal, overweight, mild obesity, and moderate to severe obesity, respectively. Linear and non-linear relationships between BMI and cortical thickness were examined using multiple linear regression analysis and generalized additive models after adjustment for potential confounders.
Among men, underweight participants showed significant cortical thinning in the frontal and temporal regions compared to normal weight participants, while overweight and mildly obese participants had greater cortical thicknesses in the frontal region and the frontal, temporal, and occipital regions, respectively. However, cortical thickness in each brain region was not significantly different in normal weight and moderate to severe obesity groups. Among women, the association between BMI and cortical thickness was not statistically significant.
Our findings suggested that underweight might be an important risk factor for pathological changes in the brain, while overweight or mild obesity may be inversely associated with cortical atrophy in cognitively normal elderly males.
The incidence of restless legs syndrome (RLS) is presumed to be higher among people with schizophrenia who take antipsychotic medication, most of which blocks the dopamine D2 receptor. The purpose of this study was to determine whether the G-protein β3 subunit (GNB3) C825T polymorphism is associated with antipsychotic-induced RLS in schizophrenia.
We examined 178 Korean patients with schizophrenia. All of the subjects were evaluated using the diagnostic criteria of the International Restless Legs Syndrome Study Group and the International Restless Legs Scale. Genotyping was performed for the C825T polymorphism in the GNB3 gene.
The genotype distribution did not differ significantly between antipsychotic-induced RLS patients and patients who had no-RLS symptoms (χ2 = 4.30, p = 0.116). The genotypes of the C825T single-nucleotide polymorphism (SNP) were classified into two groups: C+ (CC and CT genotypes) and C– (TT genotype). The presence of the C allele (C+) was associated with an increased likelihood of RLS (χ2 = 4.14, p = 0.042; odds ratio = 2.56, 95% confidence interval = 1.02–6.47).
These results suggest that the GNB3 C825T SNP is associated with RLS in schizophrenia. However, confirming this association requires future larger scale studies in which the effects of medication are strictly controlled.
New MR imaging techniques that limit artifacts in the abdomen have increased the role of MR imaging in detection and characterization of pancreatic disease. Advantages of imaging at 3T compared with 1.5T include thinner section acquisition (typically 2.5 mm versus 5 mm at 1.5T), higher matrix (typically 340 × 516 compared with 192 × 256), and high quality of T1-weighted three-dimensional (3D) gradient echo imaging . Standard sequences at 3T, which include breath-hold T1-weighted 3D gradient echo sequences, fat suppression techniques, and dynamic administration of gadolinium chelate, have resulted in image quality of the pancreas sufficient to detect and characterize focal pancreatic mass lesions smaller than 1 cm in diameter, and to evaluate diffuse pancreatic disease. MR cholangiopancreatography (MRCP) images acquired in a coronal oblique projection to delineate the pancreatic and bile duct is a useful addition. MRCP permits good demonstration of the biliary and pancreatic ducts to assess ductal obstruction, dilation, and abnormal duct pathways. The combination of parenchyma-imaging sequences and MRCP provides comprehensive information to evaluate the full range of pancreatic disease.
To examine the prevalence of food insecurity and to identify factors that contribute to it in the Republic of Korea.
A cross-sectional study.
Data were selected from a secondary data set, the third Korean Welfare Panel Study. Household food insecurity was measured with a six-item Korean version of the US Household Food Security Survey Module. The differences in proportions or means of household characteristics, householder's characteristics, economic status and social benefits by food insecurity status were tested with the χ2 or t test. The independent associations of food insecurity with each characteristic were assessed with multivariate logistic regression analysis.
The sample size consisted of 6238 households.
The prevalence of food insecurity was 5·3 % among all households and 25·7 % among low-income households. Risk factors that were associated with a higher risk of food insecurity included living alone, unemployment, no job, low household income and living in a leased or rented home. For low-income households, living in a leased or rented home increased the risk of food insecurity. Among food-insecure households, 26·1 % of the full sample of households and 34·3 % of low-income households were participating in food assistance programmes.
Food insecurity among the Korean population was related to household type, income, job status and housing. Food assistance programmes were not enough to completely alleviate food insecurity.
A post heat treatment of reaction-sintered SiC at 1700 °C in nitrogen atmosphere significantly reduced electrical resistivity. A trace of insulating Si3N4 phase was detected via nitrogen heat treatment in high-resolution transmission electron microscopy observation; however, based on x-ray photoelectron spectroscopy, the evidence of nitrogen doping into SiC lattice has been claimed as the mechanism to the decreased resistivity. The increase of the total volume of SiC was apparent in x-ray diffraction during the nitrogen heat treatment, which was interpreted to stem from the growth of the nitrogen-doped intergranular SiC particles and surface doping of the primary SiC to reduce the contact resistance between the primary SiC particles.
Ph.D.-granting institutions want students to complete their doctoral
degrees. Most graduate departments in political science focus their
training on preparing students to pursue academic careers. We
provide valid and reliable empirical data about the factors that
affect students' prospects for successfully completing political
science doctoral degrees and finding academic jobs. Because National
Science Foundation data (2002, Table 53) reveal significant
differences in the number of doctoral degrees awarded to women
compared with men, we test a series of hypotheses based on the
existing literature that may account for these differences. Our
paper applies knowledge gained from previous studies, such as in the
area of mentoring (Wasby 2001; Andersen 2001; Benesh
2001), to explain observed gender differences in doctoral
degree completion and success in gaining academic employment
thereafter.The research was
commissioned and funded by the Executive Council of the Midwest
Political Science Association; additional funding was provided
by the department of political science at the University of
Iowa. Barbara Burrell of Northern Illinois University oversaw
the data collection for round two of the panel study. Kimberly
M. Lewis of the University of Iowa provided research
Based on biophysical ice-core data collected in the landfast ice off Barrow, Alaska, USA, in 2002 and 2003, a one-dimensional ice–ocean ecosystem model was developed to determine the factors controlling the bottom-ice algal community. The data and model results revealed a three-stage ice-algal bloom: (1) onset and early slow growth stage before mid-March, when growth is limited by light; (2) fast growth stage with increased light and sufficient nutrients; and (3) decline stage after late May as ice algae are flushed out of the ice bottom. Stages 2 and 3 are either separated by a transition period as in 2002 or directly connected by ice melting as in 2003, when in situ light and nutrient enrichment experiments showed only light limitations. The modeled net primary production of ice algae (NPPAi) from March to June is 1.2 and 1.7 g Cm–2 for 2002 and 2003, respectively, within the range of previous observations. Model sensitivity studies found that overall NPPAi increased almost proportionally to the initial nutrient concentrations in the water column. A phytoplankton bloom (if it occurs as in 2002) would compete with ice algae for nutrients and lead to reduced NPPAi. About 45% of the NPPAi was exported to the shallow benthos.
The threshold voltage (VT) degradation of asymmetric source-drain a-Si:H TFTs due to the electrical stress has been investigated. In the absence of a drain bias (VG=15V, VD=0V), the threshold voltage (VT) shifts of asymmetric TFTs were similar to that of symmetric TFT. However, in the presence of drain bias (VG=15V, VD=20V), the VT shifts of asymmetric TFTs were less than symmetric TFT. The VT shifts of ‘L’ and ‘J’ shaped TFT were 0.29V, 0.24V respectively, while the VT shift of ‘I’ shaped TFT was 0.42V.
The less VT degradation of the asymmetric source-drain a-Si:H TFT compared with the symmetric TFT may be explained by the defect creation model. Since the actual drain width of asymmetric TFT is longer than symmetric TFT at the same W/L ratio, the charge depletion due to the drain bias is larger than that of the asymmetric TFT. Due to the less carrier concentration in the channel, the asymmetric a-Si:H TFT shows the less VT degradation compared with the symmetric TFT.
Metal oxide nanoparticles within the protein ferritin can act as an energy storage source in nano-bio batteries containing ferrous ferritin and a reconstituted ferritin cage containing different inorganic elements, such as Co, Mn, Ni, and Pt. These components were introduced as two ferritin half-cells with different redox potentials existing between the ferrous ferritin and the reconstituted ferritin. The reduction of ferritin was analyzed in a solution containing 3-[N-morpholino] propanesulfonic acid buffer and oxidized methyl viologen using cyclic voltammetry. The reduction and oxidation peaks of the methyl viologen occurred at potentials of −300 and −100 mV, respectively, and the reduction and the oxidation peaks of the released Fe occurred at potentials of −300 and −100 mV, respectively. The reduction of ferritin was influenced by the pH of the ferritin solution.