End-of-life care needs for noncancer patients who want to die at home in South Korea.

AIM: The awareness for the need for end-of-life care has increased among noncancer patients. However, studies on the topic have rarely targeted the needs of noncancer patients who want to die at home. This study assessed the end-of-life care needs of noncancer patients who were receiving care and wanted to die at home. METHODS: A cross-sectional study design was used and involved 200 participants who were diagnosed as noncancer patients and receiving home care nursing. Data were collected on demographics, disease, Palliative Performance Scale (PPS) scores, and end-of-life care needs, in April and May, 2016. RESULTS: Among the six areas of care, "supporting fundamental needs" of patients required the most care, followed by "coordination among family or relatives." Multivariate analysis revealed that the duration of home care nursing held a significant association with end-of-life care needs. CONCLUSION: By reflecting on the comprehensive care needs of patients with chronic illnesses and including them in the care process, it will be possible to provide better quality palliative care to patients at home in the end-of-life stages.

Uniform Ag Nanocubes Prepared by AgCl Particle-Mediated Heterogeneous Nucleation and Disassembly and Their Mechanism Study by DFT Calculation.

Uniform Ag nanocubes are reproducibly synthesized by a AgCl particle-mediated heterogeneous nucleation and disassembly process in polyol chemistry. By introducing N,N-dimethylformamide (DMF) in a conventional polyol method with HCl etchant, Ag nanocrystals (NCs) begin to be nucleated on the surface of AgCl-precipitated particles due to the promoted reduction reaction by DMF. The nucleated Ag NCs on the AgCl particles are grown to Ag nanocubes in shape by consuming Ag sources from the AgCl mother particles. Eventually the grown Ag nanocubes are disassembled from the mother AgCl particles because the AgCl particles are fully digested by the growing Ag nanocubes. Density functional theory calculation confirms that the Ag atoms can be favorably deposited on the (100) facet of AgCl particles and the Ag nuclei on the AgCl particles tend to reveal (100) facet.

Efficient hysteresis-less bilayer type CH3NH3PbI3 perovskite hybrid solar cells.

Bilayer type CH3NH3PbI3 (MAPbI3) perovskite hybrid solar cells were fabricated via a one-step spin-coating process by using solubility controlled MAPbI3 solutions of MAPbI3-DMSO (dimethyl sulfoxide) and MAPbI3-DMF (N, N-dimethylformamide)-HI. The best DMSO-bilayer device showed 1.07 ± 0.02 V V(oc) (open-circuit voltage), 20.2 ± 0.1 mA cm(-2) J(sc) (short-circuit current density), 68 ± 2% FF (fill factor), and 15.2 ± 0.3% η (overall power conversion efficiency) under the forward scan direction and 1.07 ± 0.02 V V(oc), 20.4 ± 0.1 mA cm(-2) J(sc), 70 ± 3% FF, and 15.9 ± 0.4% η under the reverse scan direction. The best HI-bilayer device had 1.08 ± 0.02 V V(oc), 20.6 ± 0.1 mA cm(-2) J(sc), 75 ± 1% FF, and 17.2 ± 0.2% η under the forward scan direction and 1.08 ± 0.02 V V(oc), 20.6 ± 0.1 mA cm(-2) J(sc), 76 ± 2% FF, and 17.4 ± 0.3% η under the reverse scan direction. The deviation of average device efficiency (η(avg)) of 20 DMSO samples and 20 HI samples was 14.2 ± 0.95% and 16.2 ± 0.85%, respectively. Therefore, the HI-bilayer devices exhibited better device efficiency and smaller J-V (current density-voltage) hysteresis with respect to the scan direction than the DMSO-bilayer devices due to the reduced recombination and traps by the formation of a purer and larger MAPbI3 perovskite crystalline film.

Clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease.

Bacterial infection is an important cause of death in patients with liver cirrhosis. The aim of this study was to investigate the clinical characteristics and prognostic impact of bacterial infection in hospitalized patients with alcoholic liver disease (ALD). We retrospectively analyzed data from 409 patients consecutively admitted to a tertiary referral center with ALD diagnosis. Of a total of 544 admissions, 133 (24.4%) cases presented with bacterial infection, of which 116 were community-acquired whereas 17 were hospital-acquired. The common types of infection were pneumonia (38%), biliary tract infection (17%), soft tissue infection (12%), and spontaneous bacterial peritonitis (9%). Diabetes, serum Na <135 mM/L, albumin <2.5 g/dL, C-reactive protein ≥20 mg/L, systemic inflammatory response syndrome (SIRS) positivity were independently associated with bacterial infection in patients with ALD. Overall 30-day and 90-day mortalities in patients with bacterial infection were significantly (P < 0.001) higher than those without infection (22.3% vs. 5.1% and 32.3% vs. 8.2%, respectively). Furthermore, bacterial infection (HR, 2.2; 95% CI, 1.049-4.579, P = 0.037), SIRS positivity (HR, 2.5; 95% CI, 1.240-4.861, P = 0.010), Maddrey's discriminant function score ≥32 (HR, 2.3; 95% CI, 1.036-5.222, P = 0.041), and hemoglobin <12 g/dL (HR, 2.4; 95% CI, 1.081-5.450, P = 0.032) were independent predictors of short-term mortality. In conclusion, bacterial infection and SIRS positivity predicted short-term prognosis in hospitalized patients with ALD. A thorough evaluation at admission or on clinical deterioration is required to detect possible infection with prompt management.

Successful treatment for conventional treatment-resistant dermatomyositis-associated interstitial lung disease with adalimumab.

Dermatomyositis (DM) is a systemic autoimmune disorder characterized by the inflammation of skeletal muscles and pathognomonic skin rashes, namely heliotrope rash and Gottron's papules and involvement of other organs. Interstitial lung disease (ILD) seems to be one of the most characteristic manifestations of the lung and associated with increased morbidity and mortality in patients with DM. Despite DM-associated ILD requires aggressive therapy with cytotoxic agents, the efficacy is questionable in some cases, and more effective and less toxic therapies are needed. Recently, although there have been several reports of successful treatment of refractory case of PM and DM with the TNF-α antagonists, including infliximab and etanercept, there was no enough evidence for DM-associated ILD. We described herein a patient with DM-associated ILD who had poor response to conventional therapies and successfully treated with adalimumab.

Dual-Task-Based Music Therapy to Improve Executive Functioning of Elderly Patients with Early Stage Alzheimer's Disease: A Multiple Case Study.

Deficits in executive functioning are a common feature of Alzheimer's disease (AD) and result from impairment in the central executive system. As a result, elderly patients with early stage AD may require interventions that are more cognitively intense than traditional interventions. To address this need, in this multiple case study, we explored a dual-task-based music therapy intervention that involved drum playing and singing designed to induce attentional and motor controls. Three octogenarians diagnosed with early stage AD participated in 12 dual-task-based music therapy sessions over 6 weeks. Measures of executive functioning and the performance of a bimanual drum tapping task were evaluated before and after the intervention. Improvements in executive functioning were observed for participants A and C. After the intervention, reduced mean synchronization errors were found for the simultaneous tapping condition for all three participants. Although there was variability in the functional changes between participants, it is noteworthy that positive improvements in the elderly patients with early stage AD were obtained following dual-task-based music therapy. The results suggest that music therapy integrated into the dual-task paradigm can be an effective way to address degenerative cognitive deficits among elderly patients with early stage AD.

Fully Scalable and Stable CsPbI2Br Solar Cells Realized by an All-Spray-Coating Process.

Spray-coating is a scalable and time-efficient technique for the development of large-area metal halide perovskite (MHP) solar cells. However, a bottleneck still exists toward the development of fully scalable n-i-p-type MHP solar cells particularly on spray-coating the hole transporting layer (HTL). Here, we present a reliable strategy of spray-coating the HTL by using MoO2 nanoparticles with small amounts of poly(triarylamine) (PTAA) binders to ensure uniform coverage and efficient charge extraction. By spray-coating all layers except the Au electrode, we achieve high and scalable efficiencies of 14.26 and 13.88% for CsPbI2Br unit cells (0.12 cm2) and submodules (25 cm2), respectively. We then extend toward an all-spray-coating process by spray-coating carbon black as the top counter electrode, resulting in a submodule efficiency of 10.08%. Finally, we also demonstrate good long-term stability of the submodules under damp heat conditions (85 °C/85% relative humidity) over 1000 h.

Dual-Task-Based Drum Playing with Rhythmic Cueing on Motor and Attention Control in Patients with Parkinson's Disease: A Preliminary Randomized Study.

Although there have been increasing reports regarding the effectiveness of dual-task interventions in rehabilitation, the scope of this research is limited to gross motor movement, such as gait among patients with Parkinson's disease (PD). To expand the dual-task paradigm to upper extremity motor and attention control in PD, drum playing with modulation of musical elements was attempted. The objective of this study was to evaluate the effects of a drum playing intervention with rhythmic cueing on upper extremity motor control and attention control in patients with PD. Twelve participants were randomly assigned to the drum playing intervention with rhythmic cueing group or the control group. The results showed that the drum playing with rhythmic cueing (DPRC) group significantly increased their sustained time of entrainment (45 BPM) and their latency time until entrainment from pretest to posttest. For the DPRC group, the latency time until entrainment was significantly improved, and improvements in cognitive measures were also found. This study shows that DPRC has great potential to improve upper extremity motor control and attention control and supports the development of new interventions that include this technique for rehabilitation in patients with PD.

Self-powered flexible all-perovskite X-ray detectors with high sensitivity and fast response.

Perovskite materials have demonstrated superior performance in many aspects of optoelectronic applications including X-ray scintillation, photovoltaic, photodetection, and so on. In this work, we demonstrate a self-powered flexible all-perovskite X-ray detector with high sensitivity and fast response, which can be realized by integrating CsPbBr3 perovskite nanocrystals (PNCs) as the X-ray scintillator with a CH3NH3PbI3 perovskite photodetector. The PNCs scintillator exhibits ultra-fast light decay of 2.81 ns, while the perovskite photodetector gives a fast response time of ∼0.3 µs and high-specific detectivity of ∼2.4×1012 Jones. The synergistic effect of these two components ultimately leads to a self-powered flexible all-perovskite X-ray detector that delivers high sensitivity of 600-1,270 µC/mGyaircm3 under X-ray irradiation and fast radiation-to-current response time.

Enhanced Weak-Light Detection of Perovskite Photodetectors through Perovskite/Hole-Transport Material Interface Treatment.

Enhancement in weak-light detection and other photodetection properties was observed for organic-inorganic halide perovskite photodetectors as a result of benzylammonium iodide (BzAI) treatment at the methylammonium lead triiodide (MAPbI3) and hole-transport layer (HTL) interface. After treatment, growth of the two-dimensional Ruddlesden-Popper perovskite phase was observed at the MAPbI3 surface, which shifted the overall surface work function upwards and thus effectively facilitated charge transfer across the MAPbI3/HTL interface. As a result, the fully fabricated device with 10 mg/mL (BzAI/isopropanol) treatment exhibited shorter rise time (trise) and decay time (tdecay) of 53 and 38 µs, respectively, compared to trise and tdecay of 214 and 120 µs, respectively, for the pristine MAPbI3 sample. In addition, the BzAI-treated device exhibited larger linearity compared to the pristine MAPbI3 sample, demonstrating a high and stable specific detectivity of 1.49 × 1013 to 2.14 × 1013 Jones under incident light intensity of 10-3 to 100 mW/cm2, respectively.

Factors Related to Frailty among the Elderly in South Korea: A 3-year Longitudinal Study.

PURPOSE: To examine factors associated with frailty among the young-old elderly (YOE) and old-old elderly (OOE). METHODS: This longitudinal study with a 3-year follow-up included 486 participants who received home care services. FINDINGS: Precipitous weight loss and depression in the YOE and worsening of complex mobility and depression in the OOE were associated with worsened frailty over the 3-year period. CONCLUSIONS: To prevent frailty, we suggest weight-loss prevention programs for the YOE, lower-limb exercise programs for the OOE, and depression management programs for both groups. IMPLICATIONS FOR NURSING PRACTICE: The findings may be used by geriatric nurses in developing programs to prevent frailty in the OOE and YOE, and in administering nursing intervention programs at nursing home centers.

Thermally Stable Inorganic CsPbI2Br Mesoscopic Metal Halide Perovskite Solar Submodules.

Highly efficient and thermally stable inorganic CsPbI2Br mesoscopic metal halide perovskite (MHP) solar cells with a poly-3-hexylthiophene (P3HT) hole transporting layer (HTL) are demonstrated by spin-washing of the P3HT HTL since the light harvesting efficiency is improved by minimizing the coabsorption of light by P3HT, and the open-circuit voltage is enhanced because of the increased valence band maximum position of the spin-washed P3HT HTL. The spin-washed CsPbI2Br MHP solar cell exhibited 1.24 V open-circuit voltage (Voc), 14.20 mA/cm2 short-circuit current density (Jsc), 81.52% fill factor (FF), and 14.35% power conversion efficiency (PCE). The unencapsulated spin-washed CsPbI2Br MHP solar cell went through 7.56% degradation after a 1000 h thermal stability test under 100 °C/25% relative humidity (RH) and simultaneous 1 sun light soaking conditions. In addition, the unencapsulated spin-washed CsPbI2Br MHP solar submodule with 25 cm2 of masked active area showed a 98% geometrical FF, 115.09 mA short-circuit current, 3.54 V Voc, 71.09% FF, and 11.58% PCE while exhibiting 8.80% of degradation during a thermal stability test at 100 °C/25% RH and 1 sun light soaking for 1000 h.

High-Performance Next-Generation Perovskite Nanocrystal Scintillator for Nondestructive X-Ray Imaging.

Readily commercializable and cost-effective next-generation CsPbBr3 perovskite nanocrystals (PNCs) based X-ray detectors are demonstrated. The PNCs-based X-ray detector exhibits higher spatial resolution (9.8 lp mm-1 at modulation transfer function (MTF) = 0.2 and 12.5-8.9 lp mm-1 for a linear line chart), faster response time (≈200 ns), and comparable stability (>40 Gyair s-1 of X-ray exposure) compared with the commercialized terbium-doped gadolinium oxysulfide (GOS)-based detectors (spatial resolution = 6.2 lp mm-1 at MTF = 0.2 and 6.3 lp mm-1 for a linear line chart, response time = ≈1200 ns) because the PNCs-based scintillator has ≈5.6-fold faster average photoluminescence lifetime and stronger emission than the GOS-based one.

[Experience of Frailty in Korean Elderly: A Phenomenological Study Utilizing the Colaizzi Method].

PURPOSE: This study attempts to explore the subjective experience of frailty among elderly individuals in Korea. METHODS: From June to August in 2014, 11 elderly persons who had experienced frailty in a community were interviewed. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. RESULTS: According to the analysis, the study participants' frailty process was structured in seven categories: (a) 'natural phenomenon with ageing,' (b) 'life force comes to an end,' (c) 'the light in my heart turns off,' (d) 'unavoidable situation,' (e) 'continuous and connected vicious cycle,' (f) 'the limit of recovery energy already passes,' and (g) 'life is supported by someones help.' CONCLUSION: The frailty experience in the participants is a natural process of aging, which cause vicious cycle acting with each other among physical, psychological, and social health. It is said that the cycle of frailty was started from weight loss and insufficient sleep, and boostered by pain. The participants from repetition of the vicious cycle become exhausted and pass the threshold of their recovery energy at some points. If they meet with sudden accidents such as falling, traffic accident and so on, they become to live a dependent life supported by someone's help in a moment. To prevent frailty and worsening conditions in Korean elderly individuals, it is recommended to provide a interventional programs using this study's results.

Two complete chloroplast genome sequences of Cannabis sativa varieties.

In this study, we determined the complete chloroplast (cp) genomes from two varieties of Cannabis sativa. The genome sizes were 153,848 bp (the Korean non-drug variety, Cheungsam) and 153,854 bp (the African variety, Yoruba Nigeria). The genome structures were identical with 131 individual genes [86 protein-coding genes (PCGs), eight rRNA, and 37 tRNA genes]. Further, except for the presence of an intron in the rps3 genes of two C. sativa varieties, the cp genomes of C. sativa had conservative features similar to that of all known species in the order Rosales. To verify the position of C. sativa within the order Rosales, we conducted phylogenetic analysis by using concatenated sequences of all PCGs from 17 complete cp genomes. The resulting tree strongly supported monophyly of Rosales. Further, the family Cannabaceae, represented by C. sativa, showed close relationship with the family Moraceae. The phylogenetic relationship outlined in our study is well congruent with those previously shown for the order Rosales.

Association study of polymorphisms in synaptic vesicle-associated genes, SYN2 and CPLX2, with schizophrenia.

BACKGROUND: The occurrence of aberrant functional connectivity in the neuronal circuit is one of the integrative theories of the etiology of schizophrenia. Previous studies have reported that the protein and mRNA levels of the synapsin 2 (SYN2) and complexin 2 (CPLX2) genes were decreased in patients with schizophrenia. Synapsin 2 and complexin 2 are involved in synaptogenesis and the modulation of neurotransmitter release. This report presents a study of the association of polymorphisms of SYN2 and CPLX2 with schizophrenia in the Korean population. METHODS: Six single nucleotide polymorphisms (SNPs) and one 5-bp insertion/deletion in SYN2 and five SNPs in CPLX2 were genotyped in 154 Korean patients with schizophrenia and 133 control patients using direct sequencing or restriction fragment length polymorphism analysis. An intermarker linkage disequilibrium map was constructed for each gene. RESULTS: Although there was no significant difference in the genotypic distributions and allelic frequencies of either SYN2 or CPLX2 polymorphisms between the schizophrenia and control groups, the two-way haplotype analyses revealed significant associations with the disease (P < 0.05 after Bonferroni correction). The three-way haplotype analyses also revealed a significant association of SYN2 with schizophrenia (P < 0.001 after Bonferroni correction). CONCLUSION: These results suggest that both SYN2 and CPLX2 may confer susceptibility to schizophrenia in the Korean population.

The role of epidemiology in the introduction of vi polysaccharide typhoid fever vaccines in Asia.

Despite the availability of at least two licensed typhoid fever vaccines--injectable sub-unit Vi polysaccharide vaccine and live, oral Ty21a vaccine--for the last decade, these vaccines have not been widely introduced in public-health programmes in countries endemic for typhoid fever. The goal of the multidisciplinary DOMI (Diseases of the Most Impoverished) typhoid fever programme is to generate policy-relevant data to support public decision-making regarding the introduction of Vi polysaccharide typhoid fever immunization programmes in China, Viet Nam, Pakistan, India, Bangladesh, and Indonesia. Through epidemiological studies, the DOMI Programme is generating these data and is offering a model for the accelerated, rational introduction of new vaccines into health programmes in low-income countries. Practical and specific examples of the role of epidemiology are described in this paper. These examples cover: (a) selection of available typhoid fever vaccines to be introduced in the programme, (b) generation of policy-relevant data, (c) providing the 'backbone' for the implementation of other multidisciplinary projects, and (d) generation of unexpected but useful information relevant for the introduction of vaccines. Epidemiological studies contribute to all stages of development of vaccine evaluation and introduction.

Parthenolide Sensitizes Human Colorectal Cancer Cells to Tumor Necrosis Factor-related Apoptosis-inducing Ligand through Mitochondrial and Caspase Dependent Pathway.

BACKGROUND/AIMS: Combination therapy utilizing tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) in conjunction with other anticancer agents, is a promising strategy to overcome TRAIL resistance in malignant cells. Recently, parthenolide (PT) has proved to be a promising anticancer agent, and several studies have explored its use in combination therapy. Here, we investigated the molecular mechanisms by which PT sensitizes colorectal cancer (CRC) cells to TRAIL-induced apoptosis. METHODS: HT-29 cells (TRAIL-resistant) were treated with PT and/or TRAIL for 24 hours. The inhibitory effect on proliferation was detected using the 3-(4, 5-dimethylthiazol-2yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Annexin V staining, cell cycle analysis, and Hoechst 33258 staining were used to assess apoptotic cell death. Activation of an apoptotic pathway was confirmed by Western blot. RESULTS: Treatment with TRAIL alone inhibited the proliferation of HCT 116 cells in a dose-dependent manner, whereas proliferation was not affected in HT-29 cells. Combination PT and TRAIL treatment significantly inhibited cell growth and induced apoptosis of HT-29 cells. We observed that the synergistic effect was associated with misregulation of B-cell lymphoma 2 (Bcl-2) family members, release of cytochrome C to the cytosol, activation of caspases, and increased levels of p53. CONCLUSION: Combination therapy using PT and TRAIL might offer an effetive strategy to overcome TRAIL resistance in certain CRC cells.

Clinical features and risk factors for severe complications among patients with acute hepatitis A virus infection in the Jeonbuk Province of Korea.

BACKGROUND/AIMS: The frequency of symptomatic acute HAV infections in adulthood are increasing in Korea. This study analyzes the clinical severity in patients with acute HAV infection and investigates risk factors associated with three severe complications: prolonged cholestasis, acute kidney injury, and acute liver failure. METHODS: We performed a retrospective analysis of 726 patients diagnosed from January 2006 to December 2010 at three tertiary hospitals in Jeonbuk Province, Republic of Korea with acute HAV infection. RESULTS: In the group of 726 patients, the mean age was 30.3 years, 426 (58.6%) were male, and 34 (4.7%) were HBsAg positive. Severe complications from acute HAV infection occurred as follows: prolonged cholestasis in 33 (4.6%), acute kidney injury in 17 (2.3%), and acute liver failure in 16 (2.2%). Through multivariate analysis, age ≥40 years (OR 2.63, p=0.024) and peak PT (INR) ≥1.5 (OR 5.81, p=0.035) were found to be significant risk factors for prolonged cholestasis. Age ≥40 years (OR 5.24, p=0.002) and female gender (OR 3.11, p=0.036) were significant risk factors for acute kidney injury. Age ≥40 years (OR 6.91, p=0.002), HBsAg positivity (OR 5.02, p=0.049), and peak total bilirubin (OR 1.11, p=0.001) were significant risk factors for acute liver failure. CONCLUSIONS: Age ≥40 years, female gender, HBsAg positivity, peak PT (INR) ≥1.5, and peak total bilirubin were significant risk factors for severe complications in acute HAV infections.