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Several studies supported the usefulness of “the surprise question” in terms of 1-year mortality of patients. “The surprise question” requires a “Yes” or “No” answer to the question “Would I be surprised if this patient died in [specific time frame].” However, the 1-year time frame is often too long for advanced cancer patients seen by palliative care personnel. “The surprise question” with shorter time frames is needed for decision making. We examined the accuracy of “the surprise question” for 7-day, 21-day, and 42-day survival in hospitalized patients admitted to palliative care units (PCUs).
This was a prospective multicenter cohort study of 130 adult patients with advanced cancer admitted to 7 hospital-based PCUs in South Korea. The accuracy of “the surprise question” was compared with that of the temporal question for clinician's prediction of survival.
We analyzed 130 inpatients who died in PCUs during the study period. The median survival was 21.0 days. The sensitivity, specificity, and overall accuracy for the 7-day “the surprise question” were 46.7, 88.7, and 83.9%, respectively. The sensitivity, specificity, and overall accuracy for the 7-day temporal question were 6.7, 98.3, and 87.7%, respectively. The c-indices of the 7-day “the surprise question” and 7-day temporal question were 0.662 (95% CI: 0.539–0.785) and 0.521 (95% CI: 0.464–0.579), respectively. The c-indices of the 42-day “the surprise question” and 42-day temporal question were 0.554 (95% CI: 0.509–0.599) and 0.616 (95% CI: 0.569–0.663), respectively.
Significance of results
Surprisingly, “the surprise questions” and temporal questions had similar accuracies. The high specificities for the 7-day “the surprise question” and 7- and 21-day temporal question suggest they may be useful to rule in death if positive.
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.
The study's aim was to examine the association of alcohol consumption with verbal and visuospatial memory impairment in older people.
Participants were 1,572, aged ≥60 years, in the hospital-based registry of the Clinical Research Center for Dementia of South Korea (CREDOS). Moderate drinking was defined as no more than seven drinks per week and three drinks per day. Memory impairment was defined as performance with more than 1 standard deviation below the mean value on the Seoul Verbal Learning Test and Rey Complex Figure Test.
Those who consumed alcohol moderately, compared with abstainers, had a lower odds of verbal memory impairment (Odds Ratio [OR] = 0.64; 95% Confidence Interval [CI]: 0.46–0.87), adjusting for covariates. Visuospatial memory, however, was not significantly associated with alcohol consumption.
Moderate alcohol drinking is associated with a reduced likelihood of verbal memory impairment among older people attending memory clinics.
To investigate whether low vitamin D status was related to insulin resistance (IR) or impaired fasting glucose (IFG) in Korean adolescents, after adjusting for total body fat mass (FM).
A cross-sectional study.
Korea National Health and Nutrition Examination Survey (KNAHNES) 2009–2010.
In total, 1466 participants (769 males) aged 10–19 years were assessed for serum 25-hydroxyvitamin D (25(OH)D) levels, for FM by whole-body dual-energy X-ray absorptiometry and for IR by homeostasis model assessment (HOMA-IR) after an 8 h fast.
Age-, sex-, season- and physical-activity-adjusted regression models showed that serum 25(OH)D levels were significantly related to markers of adiposity (P = 0·016 for FM (g), P = 0·023 for FM (%) and P = 0·035 for fat mass index). When the participants were stratified into three 25(OH)D categories (<37·5 nmol/l (n 553), 37·5 to < 50 nmol/l (n 543) and ≥ 50 nmol/l (n 370)), significantly decreasing trends were observed for fasting insulin (all P < 0·001), HOMA-IR (all P < 0·001) and the odds ratios for IFG (all P for trend < 0·05) from the lowest to the highest 25(OH)D category, after adjustments for age, sex, physical activity and all markers of adiposity. In the multivariate logistic regression analysis, the likelihood of participants in the lowest serum 25(OH)D category having IFG was 2·96–3·15 compared with those in the highest 25(OH)D category (all P < 0·05).
There was a significant inverse relationship between vitamin D status and IR and the risk of IFG, independent of adiposity, in Korean adolescents.
ZnS:Cu,Cl,Mn,Te, which shows red AC powder electroluminescence (ACPEL) emission, was synthesized using a conventional wet synthesis and a sealed vessel method. The photoluminescence (PL) and ACPEL were characterized. After the second firing, 0.5 wt% tellurium (Te)-doped ZnS:Cu,Cl,Mn,Te phosphor shows almost red PL emission from the 4T1–6A1 transition of Mn2+ ions, which are affected by the Te. Extended x-ray absorption fine structure analysis on the Mn K edge proved that the substitution of sulfur (S) with Te changes the local crystal field of the Mn2+ ions and shifts an orange emission (∼588 nm) to a red emission (∼650 nm). A red ACPEL emission is first shown in 0.5 wt%Te-doped ZnS:Cu,Cl,Mn,Te after the third firing phosphor even though its luminance is not very high. The origin of the ACPEL emission is assumed to be not a CuxS–ZnS p–n junction but a CuxTe–ZnS p–n junction. Raman spectra were characterized to support that the red ACPEL emission is probably attributed to a CuxTe–ZnS p–n junction.
Lithium based complex hydrides, including lithium aluminum hydrides and lithium borohydride (LiAlH4, Li3AlH6 and LiBH4), are among the most promising materials due to their high hydrogen contents. In the present work, we investigated the hydrogen storage properties of a new combined system of Li3AlH6-LiBH4. The samples were made with small amounts of catalyst under low energy milling conditions. Thermogravimetric analysis (TGA) of a Ti-doped Li3AlH6/2LiBH4 indicated that the degree of hydrogen release reached 7.3 wt. % by the time the sample reached 450iÆc under a heating rate of 2iÆC/min. This increased to 8.8 wt. % when the sample was held at 450iÆCfor additional 8 hours minutes under this condition. The dehydrogenation product was a mixture of LiH and AlB2. This product could be rehydrogenated up to 3.8 wt. % under 24.1 MPa hydrogen pressure and 450iÆC.
Metal hydrides and amides are potential candidate materials for hydrogen storage. Lithium- and magnesium-based material systems are among the most promising materials owing to their high hydrogen contents. In the present work, we investigated hydrogenation/dehydrogenation reactions of a binary nitride, LiMgN. LiMgN can be formed by a reaction of MgH2 with LiNH2 in 1:1 ratio. The reaction also releases approximately ∼ 8.1 wt% H2 (theoretical value is 8.2 wt%) between 160 and 220 °C. The reaction product LiMgN can be rehydrogenated by reacting with H2 under 2000 psi of hydrogen pressure and 160 °C with small amount of TiCl3 doping. TGA results showed that about 8.0 wt% of hydrogen was stored in TiCl3-doped LiMgN during the hydrogenation process. The reversible hydrogenation and dehydrogenation mechanisms involving LiMgN and H2 are discussed.
Phylogenetic analysis of the ITS rDNA region was carried out with two economically important downy mildews, Pseudoperonospora cubensis, which infects species of Cucumis, Cucurbita, and Citrullus belonging to Cucurbitaceae, and P. humuli, which infects plants of the genus Humulus belonging to Cannabaceae. Two closely related species, P. cannabina and P. celtidis, were also included to reveal taxonomic relationships with the first two mildews. All four species formed a well-resolved clade when compared with the ITS sequences of other downy mildew genera, using Bayesian inference and maximum parsimony. The P. cubensis isolates obtained from different hosts and (or) geographical origins in Korea, exhibited no intraspecific variability in the ITS sequences. The phylogenetic analyses of P. cubensis and P. humuli showed that they share a high level of sequence homology; the morphology of the sporangiophores, sporangia, and dehiscence apparatus confirmed the similarity of the two species. We therefore reduce P. humuli to the status of a taxonomic synonym of P. cubensis.
Sequence analysis of the ITS region of rDNA was used to investigate the level of genetic diversity occurring within Hyaloperonospora parasitica, and to show the relationship between phylogenies of these fungi and their hosts (Brassicaceae). Maximum parsimony and neighbour-joining analyses were performed using sequences from 32 isolates of Hyaloperonospora and Perofascia, which infect core brassicaceous hosts. For comparison, five isolates of Peronospora were also studied. The constructed phylogenetic trees showed trichotomy, showing that Hyaloperonospora, Perofascia, and Peronospora have different evolutionary histories. Although isolates from Peronospora and Perofascia clearly formed respective clades, the Hyaloperonospora group allowed separation of the isolates into four distinct clades, which shared significantly low sequence similarities. We suggest that H. parasitica infecting brassicaceous hosts should be divided into a number of distinct species. The comparison of the phylogeny of H. parasitica and that of the Brassicaceae suggests that this fungus is closely related with tribes Arabidae and Brassiceae within this host family, illustrating the potential of downy mildews for co-evolution with their hosts.
The formation of turbostratic boron nitride (tBN) phase on the cubic boron nitride (cBN) phase was investigated at specific conditions. The cBN film was deposited on the Si substrate by unbalanced magnetron sputtering. When the bias voltage at the substrate was adjusted to –85 V, the tBN phase nucleated on the cBN phase and grew simultaneously with the cBN phase. This was a critical bias voltage below which only the tBN phase was formed. The surface morphology of this film was typically shown as nodules dispersed on a very flat surface. The formation of nodulelike tBN phases seemed to be caused by a small variation of local stress on the growth surface. Once the nucleation of the nodulelike tBN phase occurred, the growth of tBN phase was accelerated. Transmission electron microscopy result showed evidence of the stress relaxation of the film caused by the formation of tBN phase at the interface of the tBN and cBN phases.
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